A 64-year-old man was admitted with unstable angina pectoris. He had been followed-up at outpatient clinics for mild to moderate aortic regurgitation and bicuspid aortic valve. He developed complete atrioventricular block (AVB) and underwent permanent pacemaker implantation 9 years previously. Cardiac catheterization showed severe stenosis at the left main trunk, as well as unexpected unrupture...

OBJECTIVES This study was designed to study the behavior of a stent deployed inside human stenotic aortic valves. BACKGROUND Endovascular valved stent (VS) implantation is a promising new therapy for patients with severe calcific aortic stenosis (AS). The precise characteristics of stent deployment in humans have been poorly studied so far. METHODS Thirty-five patients with severe AS were i...

Methods In-vivo aortic 3D hemodynamics were evaluated by MRI in 17 patients with unicuspid (n=3), bicuspid (n=9, 3 true bicuspid, 3 right-left (RL) coronary leaflet fusion, and 3 right-non (RN) coronary leaflet fusion), trileaflet (n=3), and quadricuspid aortic valves (n=2). Valve morphology and dynamics were assessed using 2D CINE MRI. Aortic blood flow was measured using ECG and respiration s...

BACKGROUND Bicuspid aortic valve regurgitation can be caused by a defect in the valve itself or by dysfunction of one or more components of the aortic root complex. A successful repair thus requires correction of all aspects of the problem simultaneously. We review our experience addressing both the valve and the aortic root when correcting bicuspid valve regurgitation. METHODS AND RESULTS Be...

OBJECTIVES Previous studies have established familial clustering of bicuspid aortic valve (BAV), presumably indicating genetic inheritance. Our objective was to statistically test whether the segregation pattern of BAV is consistent with genetic inheritance and to obtain an estimate of the size of the genetic effect (heritability). BACKGROUND Bicuspid aortic valve occurs in 1% of the populati...

OBJECTIVE Reoperation rates after repair of bicuspid aortic valves are higher than for mitral valve reconstruction. Satisfactory results have been reported for patch augmentation for tricuspid aortic valves. We have applied this technique for the repair of bicuspid aortic valves. METHODS Autologous pericardium is sutured to the free edge of the prolapsing bicuspid leaflet. A large coaptation ...

OBJECTIVES The unreinforced aortic root, in bicuspid aortic valve disease, has been shown to dilate and cause recurrent regurgitation. The objective of this study was to determine whether reduction aortoplasty can reliably prevent aortic root dilatation after aortic valve repair in bicuspid disease. METHODS A total of 66 patients, with a mean age of 41.2±12 years and with incompetent bicuspid...

The association of bicuspid aortic valve with aortic stenosis, aortic regurgitation, and infective endocarditis has been known for almost 150 years and with dissection of the aorta for 75 years. These complications are mentioned only briefly in cardiology textbooks and a standard work on medical insurance underwriting implies that it is usually a benign lesion: when diagnosed at routine medical...

The timing of prophylactic ascending aortic aneurysm surgery in the setting of bicuspid aortic valve disease is complex, with multiple factors influencing the decision. The 2014 ACC/AHA Valve guidelines recommend prophylactic replacement of the aortic root and/or ascending aorta once the aortic diameter exceeds 5.5 cm. This aortic size threshold for surgery is at a larger diameter than had been...

Objectives. Bicuspid aortic valve (AV) represents the most common form of congenital AV malformation, which is frequently associated with pathologies of the ascending aorta. We compared the mechanical properties of the aortic wall between patients with bicuspid and tricuspid AV using a new custom-made device mimicking transversal aortic wall shear stress. Methods. Between 03/2010 and 07/2011, 1...