Patient population
This was a single center retrospective study of adult patients with bicuspid aortic valve diagnosed by inpatient or outpatient transthoracic echocardiogram (TTE) or transesophageal echocardiogram (TEE) during 2013-2018 in a tertiary care center. Yale Institutional Review Board approved this study and individual consent was waived (IRB ID: 2000020356). Among 48,504 unique patients who underwent echocardiogram during that period, 245 adult patients were identified to have BAV by screening for the words “bicuspid aortic valve”, “the valve has two cusps”, or “bicuspid valve” in the echo report. For patients who were included in this study, the first diagnosis of BAV captured by our system was defined as the first echo report within the time period that mentions BAV. The echocardiogram report was manually reviewed for each patient to confirm the case definition. We recorded cases where the echo report was equivocal for the diagnosis of bicuspid valve and used the term ‘possible bicuspid aortic valve’ (Figure 1). The final date of follow-up for chart review was January 23, 2020.