Collected data and outcomes
The following patient data were collected: demographics, comorbidity, cardiology follow-up (defined as at least one visit to an outpatient cardiovascular specialist), follow-up imaging studies (echocardiogram, CT, and MRI as recommended by current guidelines), aortic diameter at imaging (dilated aorta was defined as >40mm at the aortic root or ascending aorta), the presence of other valvular pathologies, and whether the patient underwent aortic or aortic valve surgery during the study time period. CT and MRI studies were recorded based on if the indication for the study was to evaluate the valve or aorta. Cardiovascular specialist follow-up was defined as at least one outpatient cardiology or cardiothoracic surgery visit following the initial ECHO. Data collected only reflects what was captured in our health system.
To characterize follow-up patterns, we compared patients who received cardiovascular specialist follow-up to those who did not. In order to characterize how patients were followed based on aortic and valvular pathology, we also compared follow-up patterns between patients with normal versus dilated aortic diameters, as well as between patients with varying levels of aortic stenosis or regurgitation.