Progression of Aortic Dilation in Children With a Functionally Normal Bicuspid Aortic Valve

Beroukhim, Rebecca S.; Kruzick, Tracy L.; Taylor, Amy L.; Gao, Dexiang; Yetman, Anji T.

doi:10.1016/j.amjcard.2006.04.022

Cited by 117 publications

(68 citation statements)

References 6 publications

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“…However, it has been widely proven by many authors that all the segments of the ascending aorta in individuals with BAV are larger than in those with normal tricuspid AV [1,5]. Beroukhim et al [14] also proved that aortic dilatation begins in early childhood and that children born with BAV have larger dimensions in all measured regions of the aorta, especially at the level of ascending aorta.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we could not correlate information about hypertension, blood pressure, and other comorbidities in our group, which could have influenced the aortic dimensions. Notably, some authors have suggested that differences in prevalence of aortopathy in patients with BAV persist even after adjusting for blood pressure, peak aortic-jet velocity, and left ventricular ejection time [8] and is also present in persons with normal-functioning BAV [14]. We realise that the exclusion of patients who have undergone surgery or aortic valvuloplasty might have led to underestimation of the incidence, size, and pattern of aortic dilatation; however, the presented diameters of aorta are relatively high compared to those shown in studies by other authors [4].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bicuspid aortic valve morphology and its association with aortic diameter: an echocardiographic study

2016

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A b s t r a c tBackground: Bicuspid aortic valve (BAV) is strongly associated with aortopathy. Previous studies have suggested that various types of bicuspid aortic valve morphology may differently affect the aortic dilatation. Aim:To evaluate the impact of BAV cusp fusion morphology (type I -right-left coronary cusp fusion; type II -right-noncoronary cusp fusion) on the diameters of the aorta.Methods: BAV morphology was evaluated retrospectively in a group of 67 consecutive patients with BAV. The control group comprised 1000 randomly selected patients with normal tricuspid aortic valve. Aortic dimensions and other echocardiographic parameters were obtained from the echocardiography database of our department. The diameters of aorta in both BAV subtypes were evaluated at the level of: annulus, the sinus of Valsalva, the sinotubular junction, and the ascending aorta and at the level of the ascending aorta in the control group.Results: Patients with BAV were mainly male (78%), with a mean age of 55.3 ± 16.7 years. The dominant morphology of BAV in the study group was type I (n = 46; 69%). It was associated with increased aortic dimension in comparison to type II BAVs at the level of the sinuses of Valsalva (38.4 ± 5.2 vs. 34.0 ± 4.6 mm, p = 0.002), the sinotubular junction (33.1 ± 5.8 vs. 29.6 ± 5.0 mm, p = 0.035), and the ascending aorta (41.6 ± 7.1 vs. 36.6 ± 6.1 mm, p = 0.006). Indexed aortic diameter was also increased in type I BAV at the level of sinuses of Valsalva (19.6 ± 2.7 vs. 18.1 ± 1.6 mm/m 2 , p = 0.008) and the ascending aorta (21.3 ± 3.4 vs. 19.3 ± 3.4 mm/m 2 , p = 0.048). The dimensions of the ascending aorta exceeding the upper normal range limit based on control-group measurements (44.3 mm) were observed more frequently in type I than in type II (33% vs. 10%, p = 0.044). Aortic regurgitation (moderate or severe) occurred in similar percentages of both BAV subtypes (type I: 37% vs. type II: 33%, p = 0.774). There were also no significant differences in aortic valve area (2.2 ± 1.1 vs. 2.0 ± 1.4 cm 2 , p = 0.163), indexed aortic valve area (1.1 ± 0.6 vs. 1.0 ± 0.6, p = 0.337), peak transvalvular gradient (35.3 ± 20.5 vs. 39.1 ± 28.9 mm Hg, p = 0.862), and mean gradient (18.6 ± 12.3 vs. 22.7 ± 18.2 mm Hg, p = 0.571) and left ventricular ejection fraction (51.8 ± 11.6 vs. 51.8 ± 12.2%, p = 0.978) between type I and type II BAV groups.Conclusions: Type I BAV cusp fusion morphology is more commonly associated with dilatation of the aorta than type II, especially at the level of the sinus of Valsalva and the ascending aorta.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bicuspid aortic valve morphology and its association with aortic diameter: an echocardiographic study

2016

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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%

Congenital Aortic Stenosis in Childhood

Crespo¹,

Dahdah²

2011

Aortic Valve Stenosis - Current View on Diagnostics and Treatment

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“…Root enlargement is described at a younger age in patients with bicuspid valves and therefore the risk of root disease is higher in these patients. [32] The development of root pathology in patients with bicuspid valves is described later in the chapter.…”

Section: Geneticmentioning

confidence: 99%