Limitations
This study has the following limitations. Due to the retrospective
nature of this study, the availability of information such as previously
known diagnoses were limited by explicit documentation in available
notes. In addition, this was a single-center study, which limits
generalizability and raises the possibility of not capturing outside
imaging or follow-up in our analysis, although extensive search was
conducted using our electronic medical record system.
Overall, follow-up and use of surveillance imaging of the aorta or the
aortic valve may be variable despite awareness of guideline
recommendations. There is an urgent need for systematic surveillance and
implementation of clinical follow-up mechanisms to monitor this patient
population with increased risk of progressive valvulopathy and
aortopathy.