Managing Thoracic Aortic Aneurysm in Patients with Bicuspid Aortic Valve Based on Aortic Root-Involvement
نویسندگان
چکیده
Bicuspid aortic valve (BAV) can be both sporadic and hereditary, is phenotypically variable, and genetically heterogeneous. The clinical presentation of BAV is diverse and commonly associated with a high prevalence of valvular dysfunction producing altered hemodynamics and aortic abnormalities (e.g., aneurysm and dissection). The thoracic aortic aneurysm (TAA) in BAV frequently involves the proximal aorta, including the aortic root, ascending aorta, and aortic arch, but spares the aorta distal to the aortic arch. While the ascending aortic aneurysm might be affected by both aortopathy and hemodynamics, the aortic root aneurysm is considered to be more of a consequence of aortopathy rather than hemodynamics, especially in younger patients. The management of aortic aneurysm in BAV has been very controversial because the molecular mechanism is unknown. Increasing evidence points toward the BAV root phenotype [aortic root dilation with aortic insufficiency (AI)] as having a higher risk of catastrophic aortic complications. We propose more aggressive surgical approaches toward the BAV with root phenotype.
منابع مشابه
Bicuspid Aortic Valve: An Unusual Cause of Aneurysm of Left Coronary Sinus of Valsalva
Bicuspid aortic valve is traditionally considered an innocuous congenital anomaly. Due to a better and widespread availability of non-invasive imaging techniques, it has come to the fore that 30% of these cases develop complications, viz., valve abnormality (aortic regurgitation and stenosis), and aneurysm of aortic root and ascending aorta. Sinus of Valsalva aneurysm is an uncommon complicatio...
متن کاملCommentary: Managing Thoracic Aortic Aneurysm in Patients with Bicuspid Aortic Valve Based on Aortic Root-Involvement
متن کامل
Aortic Valve replacement with Reduction Aortoplasty with Mesh Prosthesis in 75 years old with Sever aortic Regurgitation with Aortic Aneurysm
Although classic and standard procedure for patients with ascending Aorta aneurysm with Sever aortic Regurgitation is Bentall surgery but in some selected cases this complex surgery was not performed with different reason like advanced age and coexisting comorbidity involving renal and hepatic and lung Function. In our cases 75 years old man with chronic renal failure ( Cr= 3.2 ) who was known ...
متن کاملAortic involvement in patients with a bicuspid aortic valve.
Bicuspid aortic valve (BAV) is one of the most common congenital heart defects. This condition is associated with significant valvular disease including aortic stenosis, aortic regurgitation, and infective endocarditis. BAV disease not only affects the aortic valve, but also the aortic root, ascending aorta, and aortic arch, all tissues originating from the neural crest. BAV may be associated w...
متن کاملAortic dilatation in patients with bicuspid aortic valve.
The association of a bicuspid aortic valve (BAV) with abnormalities of the proximal thoracic aorta, including dilatation, aneurysm and dissection, has been previously described, leading to the hypothesis of a common underlying developmental defect involving the aortic valve and the aortic wall. Consequently, any patient with BAV should receive a careful assessment not only of the valve function...
متن کامل