Bicuspid Aortic Valve Associated With Aortic Dilatation

Nkomo, Vuyisile T.; Enríquez-Sarano, Maurice; Ammash, Naser M.; Melton, L. Joseph; Bailey, Kent R.; Desjardins, Valerie A.; Horn, Robin A.; Tajik, A. Jamil

doi:10.1161/01.atv.0000055441.28842.0a

Cited by 180 publications

(116 citation statements)

References 45 publications

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“…Indeed, other studies have demonstrated that a bicuspid aortic valve is associated with a dilated aorta, regardless of the presence or absence of hemodynamically significant valve dysfunction. 8 Cystic medial degeneration has been found to be the underlying cause of the aortic dilatation associated with a bicuspid aortic valve. In one study, 75% of those with a bicuspid aortic valve undergoing aortic valve replacement surgery had biopsy-proven cystic medial necrosis of the ascending aorta, compared with only 14% of those with tricuspid aortic valves undergoing similar surgery.…”

Section: Bicuspid Aortic Valvementioning

confidence: 99%

Thoracic and Abdominal Aortic Aneurysms

2005

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Section: Bicuspid Aortic Valvementioning

confidence: 99%

Thoracic and Abdominal Aortic Aneurysms

2005

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“…Genetic diseases such as Marfan syndrome, Ehlers-Danlos syndrome, and LoeysDietz syndrome are well described, but relatively rare [3,4]. A combination of causes is assumed in patients with bicuspid aortic valve, which have a higher risk of aortic dilation or dissection, probably due to altered regional hemodynamics and structural anatomy of the aortic wall [5,6]. Inflammation has also been suggested in the development of abdominal aortic aneurysms, since cellular infiltration via vasa vasorum was observed in the aortic wall and associated with expression of inflammatory mediators [7,8].…”

Section: Introductionmentioning

confidence: 99%

Activation of endocannabinoid system is associated with persistent inflammation in human aortic aneurysm

Gestrich¹,

Dürr²,

Heinemann³

et al. 2014

Thorac cardiovasc Surg

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Human aortic aneurysms have been associated with inflammation and vascular remodeling. Since the endocannabinoid system modulates inflammation and tissue remodeling, we investigated its components in human aortic aneurysms. We obtained anterior aortic wall samples from patients undergoing elective surgery for aortic aneurysm or coronary artery disease as controls. Histological and molecular analysis (RT-qPCR) was performed, and endocannabinoid concentration was determined using LC-MRM. Patient characteristics were comparable between the groups except for a higher incidence of arterial hypertension and diabetes in the control group. mRNA level of cannabinoid receptors was significantly higher in aneurysms than in controls. Concentration of the endocannabinoid 2-arachidonoylglycerol was significantly higher, while the second endocannabinoid anandamide and its metabolite arachidonic acid and palmitoylethanolamide were significantly lower in aneurysms. Histology revealed persistent infiltration of newly recruited leukocytes and significantly higher mononuclear cell density in adventitia of the aneurysms. Proinflammatory environment in aneurysms was shown by significant upregulation of M-CSF and PPAR but associated with downregulation of chemokines. We found comparable collagen-stained area between the groups, significantly decreased mRNA level of CTGF, osteopontin-1, and MMP-2, and increased TIMP-4 expression in aneurysms. Our data provides evidence for endocannabinoid system activation in human aortic aneurysms, associated with persistent low-level inflammation and vascular remodeling.

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“…[23] Dilatation, aneurysm, and dissection may develop in patients due to loss of the structural support of the aortic wall. [23,24] According to our study, the association of aortic stenosis or aortic insufficiency with presence of a bicuspid aorta was higher than in those with a tricuspid aortic valve. The imaging of the repaired CoA should be performed at least every five years, [7] or sooner based on original anatomy and symptoms, to assess the coarctation repair site for complications such as aortic aneurysm.…”

Section: Discussionmentioning

confidence: 50%

Long-term outcomes after surgical repair of the coarctation of aorta beyond infancy period

Paç¹,

Kocabeyoğlu²,

Özen³

et al. 2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada bebeklik döneminden sonra aort koarktasyonu cerrahi olarak tamir edilen hastalarda uzun dönem sonuçlar değerlendirildi.Ça lış m a pla nı: Ocak 1999 -Ağustos 2016 tarihleri arasında aort koarktasyonunun cerrahi tamiri yapılan ve poliklinik takibinde olan toplam 49 hasta (28 erkek, 21 kadın; ort. yaş 22.9±11.3 yıl; dağılım 3-56 yıl) bu çalışmaya alındı. Tamir işlemleri yama anjiyoplasti (%51), greft interpozisyonu (%40.8), basit ve genişletilmiş uç uça anastomoz (%6.12) ve subklavyen plastidir (%2). Bul gu lar:Ortalama takip süresi 78.1±33.5 ay (dağılım 2-144 ay) idi. Hastaların 22'sinde (%44.9) rekoarktasyon, 19'unda (%38.7) hipertansiyon, üçünde (%6.1) çıkan aort anevrizması, beşinde (%10.2) aort kapak darlığı, beşinde (%10.2) aort yetmezliği ve ikisinde (%4.08) koroner arter hastalığı saptandı. İlk olarak yama anjiyoplasti yapılan hastalar ve interpozisyon greftleme yapılan hastalar arasında rekoarktasyon oranları açısından anlamlı bir fark yoktu (p= 0.787). İlk ameliyat sırasında cerrahi rekoarktasyon olan ve olmayan hastalar arasında ortalama yaş açısından istatistiksel olarak anlamlı bir fark yoktu (p= 0.696). Ancak ameliyat sonrası hipertansiyon gelişen hastaların, gelişmeyenlere kıyasla, ortalama yaşı anlamlı düzeyde yüksekti (p= 0.006). Hiçbir hastada hastane mortalitesi ve serebrovasküler olay izlenmedi.So nuç: Aort koarktasyonunun başarılı tamirinin ardından dahi, başka kalp hastalıkları gelişebilir. Bu nedenle, bu tür kalp hastalıklarının erken tanı ve tedavisi önem arz eder.Anah tar söz cük ler: Aort anevrizması; aort kapak hastalığı; aort koarktasyonu; uzun dönem. ABSTRACTBackground: This study aims to evaluate the long-term results of the patients in whom coarctation of the aorta was surgically repaired beyond the infancy period.

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Bicuspid Aortic Valve Associated With Aortic Dilatation

Cited by 180 publications

References 45 publications

Thoracic and Abdominal Aortic Aneurysms

Thoracic and Abdominal Aortic Aneurysms

Activation of endocannabinoid system is associated with persistent inflammation in human aortic aneurysm

Long-term outcomes after surgical repair of the coarctation of aorta beyond infancy period

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