Frequency of aortic root dilation in children with a bicuspid aortic valve

Gurvitz, Michelle; Chang, Ruey‐Kang R.; Drant, Stacey; Allada, Vivekanand

doi:10.1016/j.amjcard.2004.07.130

Cited by 111 publications

(63 citation statements)

References 17 publications

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“…This contrasts with the findings of other investigators that aortic dilatation is independent of the degree of stenosis. 12 Similarly, although others have found the degree of aortic dilatation to be associated with the degree of aortic insufficiency, 19 our multivariate analysis did not show any association between aortic insufficiency and the degree of ascending aorta dilatation. This finding must be considered in light of the infrequent occurrence of more than mild aortic insufficiency in our population.…”

Section: Discussioncontrasting

confidence: 61%

Dilatation of the ascending aorta in paediatric patients with bicuspid aortic valve: frequency, rate of progression and risk factors

Warren

Boyd²,

O’Connell³

et al. 2006

Heart

124

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Objectives: To describe the incidence and rate of dilatation of the ascending aorta in children with bicuspid aortic valve (BAV) and to determine factors that predict rapid aortic dilatation. Design: Retrospective cohort study. Setting: Regional tertiary care children's hospital. Patients: All children aged 0-18 years seen at the authors' institution between 1990 and 2003 with an ''isolated'' BAV. All patients had had more than one technically adequate echocardiogram, at least six months apart, with concomitant height and weight data. Interventions: Offline echocardiographic measurements of multiple levels of the aortic root were completed for each participant at each serial echocardiogram. These measurements were then compared with expected measurements derived from a normal local control population. Main outcome measures: Rate of change of the ascending aorta size over time, where aortic size is expressed as the number of standard deviations above or below the mean size expected for a given body surface area (z score). Results: 279 echocardiograms spanning a period of from 9 months to 13.3 years were analysed for 88 patients with BAV. The ascending aorta in the BAV group was larger than expected for body surface area at diagnosis and continued to increase in relative size at each of the four subsequent follow-up echocardiograms. Ascending aortic z score increased at an average rate of 0.4/year. A faster rate of increase in z score was predicted by both larger initial aortic valve gradient and non-use of b blockers. Conclusions: Children with BAV are at risk of having a dilated ascending aorta. This risk increases with longer follow up.

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Section: Discussioncontrasting

confidence: 61%

Dilatation of the ascending aorta in paediatric patients with bicuspid aortic valve: frequency, rate of progression and risk factors

Warren

Boyd²,

O’Connell³

et al. 2006

Heart

124

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“…1), have predictive value in determining which BAV morphology variants would be at greater risk of developing aortic dilatation. In order to validate this hypothesis, clinical studies have been performed [35,15] evaluating the WSS in BAV patients from MRI measurements. WSS is computed by a finite difference approximation based upon the velocity data and the blood viscosity measure.…”

Section: Variational Assimilation Of Velocity Data For the Incompressmentioning

confidence: 99%

Applications of variational data assimilation in computational hemodynamics

D’Elia

Mirabella

Passerini

et al. 2012

MS&A

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The development of new technologies for acquiring measures and images in order to investigate cardiovascular diseases raises new challenges in scientific computing. These data can be in fact merged with the numerical simulations for improving the accuracy and reliability of the computational tools. Assimilation of measured data and numerical models is well established in meteorology, whilst it is relatively new in computational hemodynamics. Different approaches are possible for the mathematical setting of this problem. Among them, we follow here a variational formulation, based on the minimization of the mismatch between data and numerical results by acting on a suitable set of control variables. Several modeling and methodological problems related to this strategy are open, such as the analysis of the impact of the noise affecting the data, and the design of effective numerical solvers. In this chapter we present three examples where a mathematically sound (variational) assimilation of data can significantly improve the reliability of the numerical models. Accuracy and reliability of computational models are increasingly important features in view of the progressive adoption of numerical tools in the design of new therapies and, more in general, in the decision making process of medical doctors.

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“…Pure aortic incompetence due to a prolapsed leaflet may occur in childhood but is more likely to develop and progress later in time; nevertheless, this remains an infrequent cause of intervention requirement even in adults. Aortic root dilatation has been documented in childhood, suggesting that this process begins early in life (Beroukhim et al, 2006;Gurvitz et al, 2004). Its progression is more likely in children with a larger aorta at baseline, but it is extremely rare to necessitate intervention before adulthood (Holmes et al, 2007).…”

Section: Natural Coursementioning

confidence: 99%