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The congenitally bicuspid aortic valve: how does it function? Why does it fail?

Francis Robicsek1, Mano J Thubrikar, Joseph W Cook

  • 1Carolinas Heart Institute at Carolinas Medical Center, Charlotte, North Carolina 28203, USA. frobicsek@sanger-clinic.com

The Annals of Thoracic Surgery
|January 17, 2004
PubMed
Summary
This summary is machine-generated.

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Congenitally bicuspid aortic valves (CBAVs) show abnormal function, including excessive folding and turbulent flow. These factors contribute to high early failure rates and potential aortic complications.

Area of Science:

  • Cardiovascular research
  • Biomedical engineering
  • Cardiac surgery

Background:

  • Congenitally bicuspid aortic valves (CBAVs) often present with good initial function but have a high rate of early failure.
  • Understanding the underlying mechanisms of CBAV dysfunction is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the functional characteristics of "normal" appearing congenitally bicuspid aortic valves (CBAVs).
  • To identify the hemodynamic and morphologic factors contributing to the early failure of CBAVs.

Main Methods:

  • Analysis of cryopreserved human aortic roots with CBAVs.
  • Assessment of valvular function using a left heart simulator.
  • High-speed cinematography (500 frames/second) and intravascular ultrasound.

Related Experiment Videos

  • Silicone molding and computerized digital modeling for detailed morphologic and flow analysis.

    • Main Results:

    • Clinically "normal" CBAVs exhibit persistent excessive leaflet folding and creasing throughout the cardiac cycle.
    • Extended leaflet contact areas, significant morphologic stenosis, and asymmetrical, turbulent flow patterns were observed.
    • These functional abnormalities lead to increased mechanical stress on the valve leaflets.

    Conclusions:

    • The observed functional and hemodynamic abnormalities in CBAVs predispose them to early thickening, calcification, and stenosis.
    • Abnormal flow dynamics associated with CBAVs may also contribute to ascending aorta dilatation and dissection.
    • These findings highlight critical factors driving CBAV degeneration and failure.