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Bicuspid aortic valve and associated aortopathy: surgical considerations
Brian A Bruckner1, Michael J Reardon
1Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.
Methodist Debakey Cardiovascular Journal
|April 3, 2010
Summary
Bicuspid aortic valve (BAV), a common congenital heart defect, affects 0.5-2% of the population. BAV often leads to aortic stenosis and requires specific surgical considerations due to associated aortic pathologies.
Area of Science:
- Cardiology
- Genetics
- Congenital Heart Disease
Background:
- The human aortic valve is typically tricuspid but can present as bicuspid or quadricuspid.
- Bicuspid aortic valve (BAV) is the most common congenital heart anomaly in adults, affecting 0.5-2% of the population.
- BAV is an inherited defect with an autosomal dominant inheritance pattern.
Purpose of the Study:
- To review the pathology and clinical implications of bicuspid aortic valve.
- To highlight the unique surgical considerations for BAV compared to other aortic valve diseases.
Main Methods:
- Literature review of congenital heart anomalies, focusing on BAV.
- Analysis of epidemiological data from echocardiography and autopsy series.
- Review of clinical outcomes and surgical management strategies for BAV.
Main Results:
- BAV is a frequent congenital anomaly, causing significant aortic stenosis in pediatric (70-85%) and adult (50%) cases.
- Pathology in BAV extends beyond leaflets to the left ventricular outflow tract and ascending aorta.
- BAV is associated with congenital anomalies, infective endocarditis, and thoracic aortic emergencies (aneurysm, dissection).
Conclusions:
- BAV necessitates distinct surgical planning due to its extensive pathology and associated risks.
- Early recognition and management of BAV are crucial for preventing severe cardiovascular complications.
- BAV management requires a comprehensive approach addressing valve function and aortic integrity.
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