{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T07:22:32Z","timestamp":1773472952029,"version":"3.50.1"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,4,4]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Description of cerebral and retinal infarction in patients with bicuspid aortic valve (BAV) is limited to case reports. We aimed to characterize cerebral and retinal infarction and examine outcomes in patients with BAV.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Consecutive patients from 1975 to 2015 with BAV (n=5401) were retrospectively identified from the institutional database; those with confirmed cerebral or retinal infarction were analyzed. Infarction occurring after aortic valve replacement was not included. Patients were grouped according to infarction pathogenesis: embolism from a degenerative calcific BAV (BAVi); non\u2010BAV, large artery atherosclerotic or lacunar infarction (LAi); and non\u2010BAV, non\u2010large artery embolic infarction (nLAi). There were 83\/5401 (1.5%) patients, mean age 54\u00b112\u2009years and 28% female, with confirmed cerebral or retinal infarction (LAi 23\/83 [28%]; nLAi 30\/83 [36%]; BAVi 26\/83 [31%]; other 4\/83 [5%]). Infarction was embolic in 72\/83 (87%), and 35\/72 (49%) were cardioembolic. CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc score was 1.4\u00b11.2 in BAVi (\n              <jats:italic>P<\/jats:italic>\n              =0.188 versus nLAi) and 2.3\u00b11.2 in LAi (\n              <jats:italic>P<\/jats:italic>\n              =0.005). Recurrent infarction occurred in 41% overall (50% BAVi,\n              <jats:italic>P<\/jats:italic>\n              =0.164 and 0.803 versus LAi and nLAi). BAVi was more commonly retinal (39% BAVi versus 13% LAi,\n              <jats:italic>P<\/jats:italic>\n              =0.044 versus 0% nLAi,\n              <jats:italic>P<\/jats:italic>\n              =0.002). Patients with BAVi and LAi were more likely to have moderate\u2010to\u2010severe aortic stenosis and undergo aortic valve replacement compared with patients with nLAi.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Cardioembolism, often from degenerative calcification of the aortic valve, is a predominant cause of cerebral and retinal infarction in patients with BAV and is frequently recurrent. Cerebral and retinal infarction should be regarded as a complication of BAV.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.028789","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T10:48:46Z","timestamp":1679395726000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Cerebral and Retinal Infarction in Bicuspid Aortic Valve"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7681-1107","authenticated-orcid":false,"given":"Geoffrey D.","family":"Huntley","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2341-5247","authenticated-orcid":false,"given":"Hector I.","family":"Michelena","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy J.","family":"Thaden","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7856-7048","authenticated-orcid":false,"given":"Adham K.","family":"Alkurashi","sequence":"additional","affiliation":[{"name":"Department of Surgery Jefferson Health \u2013 Abington PA Abington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorin V.","family":"Pislaru","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Pochettino","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Mayo Clinic Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-1478","authenticated-orcid":false,"given":"Juan A.","family":"Crestanello","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Mayo Clinic Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3239-6460","authenticated-orcid":false,"given":"Joseph J.","family":"Maleszewski","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Robert D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6095-5579","authenticated-orcid":false,"given":"Vuyisile T.","family":"Nkomo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2009.07.018"},{"key":"e_1_3_1_3_2","first-page":"173","article-title":"Spontaneous and simultaneous bicuspid aortic valve and aorta thrombosis","volume":"27","author":"Shabtaie SVV","year":"2018","unstructured":"Shabtaie SVV, Michelena HI. Spontaneous and simultaneous bicuspid aortic valve and aorta thrombosis. J Heart Valve Dis. 2018;27:173\u2013177.","journal-title":"J Heart Valve Dis."},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2008.10.011"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2020.06.009"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.028389"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.27.5.847"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.11.2628"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.015200"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.27.2.197"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.11.024"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.005296"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01167-X"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.05.032"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2009.03.006"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(79)90704-9"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.122.028789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T12:52:40Z","timestamp":1715604760000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.122.028789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,4]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,4,4]]}},"alternative-id":["10.1161\/JAHA.122.028789"],"URL":"https:\/\/doi.org\/10.1161\/jaha.122.028789","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,4]]},"assertion":[{"value":"2022-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e028789"}}