Patterns of Aortic Dilatation in Bicuspid Aortic Valve–Associated Aortopathy

2013 ◽  
Vol 26 (6) ◽  
pp. 600-605 ◽  
Author(s):  
Clarence Khoo ◽  
Christopher Cheung ◽  
John Jue
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Dilatation

Collagen analysis of the ascending aortic dilatation associated with bicuspid aortic valve disease compared with tricuspid aortic valve

2016 ◽  
Vol 122 (5) ◽  
pp. 289-294 ◽  
Author(s):  
Alexander Navarrete Santos ◽  
Junfeng Yan ◽  
Peter Lochmann ◽  
Heike Pfeil ◽  
Michael Petersen ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Valve Disease ◽  
Valve Disease ◽  
Aortic Dilatation ◽  
Tricuspid Aortic Valve ◽  
Collagen Analysis

scholarly journals Ascending Aortic Dilatation Associated With Bicuspid Aortic Valve

Circulation ◽  
2009 ◽  
Vol 119 (6) ◽  
pp. 880-890 ◽  
Author(s):  
Thomas M. Tadros ◽  
Michael D. Klein ◽  
Oz M. Shapira
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Dilatation

Measurement of Valve Lesion Morphology and Aorta / Flow-Jet Patterns in Bicuspid Aortic Valve Patients

2009 ◽  
Author(s):  
Alex J. Barker ◽  
Craig Lanning ◽  
Robin Shandas
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Complex Disease ◽  
Aortic Dilatation ◽  
Hemodynamic Forces ◽  
Significant Incidence ◽  
Valve Opening ◽  
Valve Lesion ◽  
And Function ◽  
Lesion Morphology

Bicuspid aortic valve (BAV) patients are identified by a lesion of the tricuspid aortic leaflets in which only two ‘functional’ leaflets are visibly present. This lesion occurs in 0.5–2% of the population and is accompanied by a significant incidence of morbidity and mortality related to aortic valve dysfunction, aortic dilatation, aortic aneurysm, and aortic dissection. [1] The pathogenesis of the malformation has been postulated to be the result of a congenital or inflammatorily-mediated fusion of two of the three aortic leaflets. In addition, BAV is accompanied by a variety of heterogeneous complications and is considered a complex disease with many cofactors, the importance of which continue to be debated. Among these cofactors, the most commonly identified vascular manifestation is aortic dilatation. [1] There are two hypotheses for this manifestation: the first postulates the coexistence of BAV and genetically-based aortic fragility; the second proposes that BAV morphology and incomplete valve opening induces hemodynamic forces that influence structure and function at the aorta.

scholarly journals Variability of repairable bicuspid aortic valve phenotypes: towards an anatomical and repair-oriented classification†

2019 ◽  
Vol 56 (2) ◽  
pp. 351-359 ◽  
Author(s):  
Laurent de Kerchove ◽  
Stefano Mastrobuoni ◽  
Lennart Froede ◽  
Saadallah Tamer ◽  
Munir Boodhwani ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Classification System ◽  
Type A ◽  
Aortic Insufficiency ◽  
Aortic Dilatation ◽  
Valve Repair ◽  
Type C ◽  
Anatomical Parameters ◽  
Repair Techniques

AbstractOBJECTIVESThe bicuspid aortic valve (BAV) exists in a wide variety of valve phenotypes. The aim of this study was to assess the anatomical characteristics of the different phenotypes and develop a classification system to aid surgical repair.METHODSIn 178 consecutive patients operated on for aortic insufficiency or aortic dilatation in 2 centres, 11 anatomical parameters of BAV were measured by echocardiography and intraoperatively. All BAV judged potentially repairable were included in the study.RESULTSCommissural orientation correlated positively with fusion length (R2 = 0.6, P < 0.001) and negatively with non-functional commissure height (R2 = 0.45, P < 0.001). The cohort was divided into 3 groups according to their commissural orientation (type A: symmetrical, 160–180°, n = 73; type B: asymmetrical, 140–159°, n = 74; and type C: very asymmetrical, 120–139°, n = 31). The patterns of cusp fusion, annulus and aortic size were similar among the groups. Fusion length and the geometric height of the cusps decreased from type A to C; non-functional commissure height increased from type A to C (P < 0.05). Patient age increased from type A to type C. Isolated aortic dilatation was more frequent in type A, and severe aortic insufficiency was more frequent in types B and C (P < 0.05). Valve repair techniques and management of commissural orientation varied among the 3 groups (P < 0.05). Aortic valve replacement and residual aortic insufficiency after repair were more frequent in type C (P < 0.05).CONCLUSIONSThe BAV phenotypes follow a continuous spectrum that extends from symmetrical to very asymmetrical BAV. We describe the main anatomical parameters (including commissure orientation, length of fusion and non-functional commissure height) and their variation across this spectrum. We propose a new repair-oriented classification system based on those parameters that can be used to predict valve repair techniques. This classification needs further validation with regards to surgical techniques and long-term outcomes.

scholarly journals Differences in Aortopathy in Patients with a Bicuspid Aortic Valve with or without Aortic Coarctation

2020 ◽  
Vol 9 (2) ◽  
pp. 290
Author(s):  
Anthonie Duijnhouwer ◽  
Allard van den Hoven ◽  
Remy Merkx ◽  
Michiel Schokking ◽  
Roland van Kimmenade ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Bicuspid Aortic Valve ◽  
Aortic Coarctation ◽  
Care Center ◽  
Aortic Surgery ◽  
Tertiary Care ◽  
Aortic Diameter ◽  
Aortic Dilatation ◽  
Significant Difference

Objective: The combination of aortic coarctation (CoA) and bicuspid aortic valve (BAV) is assumed to be associated with a higher risk of ascending aortic dilatation and type A dissection, and current European Society of Cardiology (ESC) guidelines advise therefore to operate at a lower threshold in the presence of CoA. The aim of our study is to evaluate whether the coexistence of CoA in BAV patients is indeed associated with a higher risk of ascending aortic events (AAE). Methods: In a retrospective study, all adult BAV patients visiting the outpatient clinic of our tertiary care center between February 2003 and February 2019 were included. The primary end point was an ascending aortic event (AAE) defined as ascending aortic dissection/rupture or preventive surgery. The secondary end points were aortic dilatation and aortic growth. Results: In total, 499 BAV patients (43.7% female, age 40.3 ± 15.7 years) were included, of which 121 (24%) had a history of CoA (cBAV). An aortic event occurred in 38 (7.6%) patients at a mean age of 49.0 ± 13.6 years. In the isolated BAV group (iBAV), significantly more AAE occurred, but this was mainly driven by aortic valve dysfunction as indication for aortic surgery. There was no significant difference in the occurrence of dissection or severely dilated ascending aorta (>50 mm) between the iBAV and cBAV patients (p = 0.56). The aortic diameter was significantly smaller in the cBAV group (30.3 ± 6.9 mm versus 35.7 ± 7.6 mm; p < 0.001). The median aortic diameter increase was 0.23 (interquartile range (IQR): 0.0–0.67) mm/year and was not significantly different between both groups (p = 0.74). Conclusion: Coexistence of CoA in BAV patients was not associated with a higher risk of aortic dissection, preventive aortic surgery, aortic dilatation, or more rapid aorta growth. This study suggests that CoA is not a risk factor in BAV patients, and the advice to operate at lower diameter should be reevaluated.

scholarly journals Volumetric quantification of absolute local normalized helicity in patients with bicuspid aortic valve and aortic dilatation

2016 ◽  
Vol 78 (2) ◽  
pp. 689-701 ◽  
Author(s):  
Julio Garcia ◽  
Alex J. Barker ◽  
Jeremy D. Collins ◽  
James C. Carr ◽  
Michael Markl
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Dilatation ◽  
Volumetric Quantification

scholarly journals Bicuspid Aortic Valve Disease and Ascending Aortic Aneurysms: Gaps in Knowledge

2012 ◽  
Vol 2012 ◽  
pp. 1-16 ◽  
Author(s):  
Katie L. Losenno ◽  
Robert L. Goodman ◽  
Michael W. A. Chu
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Valve Disease ◽  
Aortic Aneurysms ◽  
Valve Disease ◽  
Cardiac Anomaly ◽  
Aortic Dilatation ◽  
Congenital Cardiac Anomaly ◽  
Valvular Stenosis ◽  
Ongoing Surveillance

The bicuspid aortic valve is the most common congenital cardiac anomaly in developed nations. The abnormal bicuspid morphology of the aortic valve results in valvular dysfunction and subsequent hemodynamic derangements. However, the clinical presentation of bicuspid aortic valve disease remains quite heterogeneous with patients presenting from infancy to late adulthood with variable degrees of valvular stenosis and insufficiency and associated abnormalities including aortic coarctation, hypoplastic left heart structures, and ascending aortic dilatation. Emerging evidence suggests that the heterogeneous presentation of bicuspid aortic valve phenotypes may be a more complex matter related to congenital, genetic, and/or connective tissue abnormalities. Optimal management of patients with BAV disease and associated ascending aortic aneurysms often requires a thoughtful approach, carefully assessing various risk factors of the aortic valve and the aorta and discerning individual indications for ongoing surveillance, medical management, and operative intervention. We review current concepts of anatomic classification, pathophysiology, natural history, and clinical management of bicuspid aortic valve disease with associated ascending aortic aneurysms.

Sign in / Sign up

Export Citation Format

Share Document