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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
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Bicuspid aortic valve associated aortopathy: 2022 guideline update
Raj Verma1, Gideon Cohen2, Jillian Colbert3
1Royal College of Surgeons in Ireland, Dublin, Ireland.
Current Opinion in Cardiology
|January 31, 2023
Summary
Bicuspid aortic valve (BAV) disease can cause aortic dilatation (BAV aortopathy), increasing risks of dissection or rupture. Management requires personalized decisions based on aortic size, valve function, and growth rate, guided by 2022 ACC/AHA guidelines.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Genetics
Background:
- Bicuspid aortic valve (BAV) affects 1-2% of the population, often leading to aortic stenosis, regurgitation, and proximal aortic dilatation (BAV aortopathy).
- BAV aortopathy can progress independently of valve function, potentially causing aortic aneurysms, dissection, or rupture.
- This review aligns clinical decision-making for BAV aortopathy with the latest 2022 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines.
Approach:
- The review synthesizes the ACC/AHA 2022 guidelines for diagnosing and managing aortic pathologies.
- It details recommended thresholds for aortic root and ascending aorta replacement.
- It highlights Class 2A and 2B recommendations for early intervention, emphasizing experienced surgeons and multidisciplinary aortic teams (MATs).
Key Points:
- BAV aortopathy is a prevalent and complex condition.
- Intervention timing is individualized, considering aortic dimensions, valve status, growth rate, and patient-specific factors.
- Multidisciplinary aortic teams (MATs) and surgical expertise are crucial for optimal outcomes.
Conclusions:
- Effective management of BAV aortopathy necessitates a personalized strategy.
- Adherence to 2022 ACC/AHA guidelines ensures contemporary care for patients with BAV.
- A collaborative, multidisciplinary approach improves decision-making and patient management for BAV aortopathy.
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