The bicuspid aortic valve and its relation to aortic dilation

Area of Science:

• Cardiovascular Medicine
• Congenital Heart Disease
• Cardiac Surgery

Background:

• Bicuspid aortic valve (BAV) affects 1-2% of the population, yet its link to aortic dilation requires further elucidation.
• Understanding BAV's impact on aortic dimensions is crucial for managing this common congenital heart defect.

Purpose of the Study:

• To investigate the relationship between BAV and aortic dilation.
• To compare clinical, morphological, and laboratory findings between BAV and tricuspid aortic valve (TAV) patients.

Main Methods:

• Retrospective analysis of 241 BAV patients undergoing cardiac surgery.
• Comparison of BAV patients with TAV patients regarding aortic valve morphology, aortic dimensions, left main coronary artery length, and laboratory parameters.
• Assessment of the impact of statin therapy on aortic dimensions.

Main Results:

• BAV patients were younger, predominantly male, and often presented with stenotic or regurgitant valves.
• BAV patients exhibited a shorter left main coronary artery and smaller aortic dimensions (root, sinotubular junction, ascending aorta) compared to TAV patients.
• Aortic dilation in BAV patients was significantly associated with age; statin therapy reduced aortic dimensions but had a lesser effect in BAV patients.

Conclusions:

• BAV is associated with earlier onset of aortic wall and valve disorders, predominantly in males.
• Aortic dilation occurs in both BAV and TAV patients, but to a lesser extent in BAV patients and is age-related.
• Shorter left main coronary artery in BAV patients may contribute to progressive aortic dilation; statin therapy's benefits on aortic dimensions were less pronounced in BAV patients.