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.