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Atrioventricular block as the initial presentation of calcified bicuspid aortic valve

Reza Karbasi-Afshar1, Nematollah Jonaidi-Jafari2, Amin Saburi3

  • 1Department of Cardiovascular Diseases, School of Medicine AND Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

ARYA Atherosclerosis
|June 26, 2014
PubMed

Insights

Bicuspid aortic valve (BAV) can lead to severe heart conditions. Early diagnosis and management are crucial to prevent complications like irreversible atrioventricular block after aortic valve replacement.

Area of Science:

  • Cardiology
  • Congenital Heart Disease

Background:

  • Bicuspid aortic valve (BAV) is a common congenital heart defect in adults.
  • Delayed diagnosis of congenital heart disorders can lead to disease progression and complications.

Observation:

  • A 34-year-old male with BAV presented with cardiac shock due to complete heart block, requiring pacemaker implantation.
  • Echocardiography revealed a thick, calcified bicuspid aortic valve with aortic insufficiency, stenosis, and a dilated ascending aorta.
  • The patient underwent aortic valve replacement, ascending aorta aneurysm repair (Bentall procedure), and ICD implantation.

Findings:

  • Thick, calcified aortic root is a potential risk factor for atrioventricular (AV) block post-aortic valve replacement (AVR).
  • Irreversible AV block necessitating permanent pacemaker (PPM) implantation is a rare complication following AVR.

Implications:

  • Preoperative assessment for conductive disorders is essential in AVR candidates, particularly those with calcified valves.
  • Understanding risk factors for AV block can improve patient outcomes after AVR.
Abstract

Keywords:
Atrioventricular BlockBicuspid Aortic ValveCalcified Valve

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