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Aortopathy in Bicuspid Aortic Valve: Pathophysiology, Risk Stratification and Surgical Decision-Making-A Narrative
Sebastian Krych1,2, Julia Gniewek2, Michał Jurkiewicz3
1Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, School of Medical Sciences in Zabrze, Medical University of Silesia, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland.
Journal of Clinical Medicine
|May 13, 2026
Summary
Bicuspid aortic valve (BAV) is a common congenital heart defect causing hemodynamic issues. Understanding its causes, risks, and varied treatment options is crucial for patient outcomes.
Area of Science:
- Cardiology
- Congenital Heart Defects
- Vascular Biology
Background:
- Bicuspid aortic valve (BAV) is a prevalent congenital heart defect.
- It significantly disrupts normal circulatory hemodynamics.
- BAV is associated with aortopathy and genetic disorders like Marfan syndrome.
Purpose of the Study:
- To review the etiopathogenesis, complications, and risks of BAV.
- To synthesize current pharmacological and surgical treatment strategies.
- To emphasize indications and contraindications for surgical interventions.
Main Methods:
- Narrative review of articles published between 2012 and 2025.
- Literature indexed in PubMed was analyzed.
- Key information on BAV was synthesized.
Main Results:
- Isolated BAV with typical valvular aortopathy has a better prognosis than aortopathy syndromes.
- BAV alters blood flow dynamics, potentially weakening the aortic wall.
- Valve phenotype exhibits sex-related differences in presentation and progression.
Conclusions:
- BAV management requires careful consideration due to heterogeneous aortopathies.
- Optimal timing and surgical strategy for BAV interventions present challenges.
- Further research is needed to refine treatment approaches for BAV-associated aortopathies.
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