Related Experiment Video
Updated: May 4, 2026
08:50
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
10.9K
Surgical thresholds for bicuspid aortic valve associated aortopathy
Ashutosh A Hardikar1, Thomas H Marwick1
1Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia.
JACC. Cardiovascular Imaging
|December 17, 2013
Summary
The natural history of aortopathy associated with bicuspid aortic valve (BAV) shows a low acute aortic event risk in current practice. Intervention timing for BAV patients should balance this low risk against surgical morbidity and mortality.
Area of Science:
- Cardiology
- Vascular Surgery
- Genetics
Background:
- Aortopathy is a common complication in patients with bicuspid aortic valve (BAV).
- Early intervention for BAV-associated aortopathy is proposed to mitigate dissection risk.
- Current surgical timing relies on imaging and expert opinion due to limited natural history data.
Purpose of the Study:
- To systematically review the natural history of aortopathy in patients with BAV.
- To evaluate outcomes after interventions for BAV-associated aortopathy.
- To define the risks associated with BAV to inform surgical timing decisions.
Main Methods:
- Systematic review of observational studies on BAV up to June 2013.
- Primary outcome: annualized all-cause mortality.
- Secondary outcomes: acute aortic events, aneurysm enlargement rates, peri-operative complications.
- Meta-regression analysis to assess covariate impact.
Main Results:
- Included 11,045 patients (9,441 BAV, 1,604 controls).
- Annualized mortality in nonoperated BAV patients was 0.56%.
- Annualized acute event rate in nonoperated BAV patients was 0.29%, similar to tricuspid aortic valve.
- Aortic dilation rate was 0.16 mm/year in healthy BAV subjects.
Conclusions:
- The risk of BAV-associated aortopathy varies with age and clinical context.
- Despite aortic dilation, the acute aortic event risk in BAV patients is currently low.
- Intervention timing requires balancing low event risk against surgical risks.
Related Concept Videos
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
1.2K
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
1.2K
01:25Aortic Regurgitation III: Medical Management
598
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
598
01:26Aneurysm III: Interprofessional Care
478
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
478
01:15Aortic Regurgitation I: Introduction
1.6K
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
1.6K
01:26Mitral Stenosis III: Medical Management
535
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
535
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
589
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
589