Bicuspid aortic stenosis treatment overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Approximately 40% of patients with a bicuspid aortic valve potentially require aortic valve replacement in the third or fourth decade of their life.

Concomitant Disease of the Aorta

The aorta of patients with bicuspid aortic valve does not have the same histological characteristics of a normal aorta. The tensile strength is reduced. These patients are at a higher risk for aortic dissection and aneurysm formation of the ascending aorta. The size of the proximal aorta should be evaluated carefully during the evaluation of the patient for aortic stenosis surgery. The initial diameter of the aorta should be noted and periodic evaluation with CT scan (every year or sooner if there is a change in aortic diameter) should be recommended. Therefore, if the patient needs surgery, the size of the aorta will determine what type of surgery should be offered to the patient. [1][2]

Associated Congenital Heart Disease

Patients with bicuspid aortic valve are also at higher risk of aortic coarctation, an abnormal narrowing of the thoracic aorta [3].

References

  1. Cohn LH, Edmunds LH Jr. Cardiac Surgery in the Adult. McGraw-Hill, 2003.
  2. C. M. Otto, I. G. Burwash, M. E. Legget, B. I. Munt, M. Fujioka, N. L. Healy, C. D. Kraft, C. Y. Miyake-Hull & R. G. Schwaegler (1997). "Prospective study of asymptomatic valvular aortic stenosis. Clinical, echocardiographic, and exercise predictors of outcome". Circulation. 95 (9): 2262–2270. PMID 9142003. Unknown parameter |month= ignored (help)
  3. Cohn LH, Edmunds LH Jr. Cardiac Surgery in the Adult. McGraw-Hill, 2003.

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