The bicuspid aortic valve: Is it an immunological disease process?

Abstract

Bicuspid aortic valves (BAVs) are the most common congenital cardiac condition and are characterized by a structural abnormality whereby the aortic valve is composed of two leaflets instead of being trileaflet. It is linked to an increased risk for a variety of complications of the aorta, many with an immunological pathogenesis. The aim of this study is to review and analyze the literature regarding immunological processes involving BAVs, associated common pathologies, and their incidence in the population. This study will also examine current trends in surgical and therapeutic approaches to treatment and discuss the future direction of BAV treatment. K E Y W O R D S aorta, bicuspid aortic valve, immunology, immunopathology J Card Surg. 2019;34:482-494. wileyonlinelibrary.com/journal/jocs

The genetics and biomechanics of thoracic aortic diseases

“…Similarly, patients with Turner syndrome (TS) are predisposed to a myriad of cardiovascular malformations: aortic dissection, coarctation, congenital bicuspid aortic valve, persistent left superior vena cava and various left-sided malformations are common and lead to 41% of cardiovascular events in TS patients (22). Aortic root dilatation is often present and thought to be blood pressure dependent, with it eventually forming aneurysms and dissections (22,23). Hypertension aside, congenital bicuspid aortic valves, coarctation and short stature of female TS patients also predisposes aortic dilatation and dissection (22,23,24).…”

“…Aortic root dilatation is often present and thought to be blood pressure dependent, with it eventually forming aneurysms and dissections (22,23). Hypertension aside, congenital bicuspid aortic valves, coarctation and short stature of female TS patients also predisposes aortic dilatation and dissection (22,23,24). Ascending aorta diameter in short female TS patients are significantly wider than healthy cohorts and is responsible for increased incidence of up to 618 cases/100,000 woman-years compared to under 3/100,000 annually (25).…”

Dual role for CXCL12 signaling in semilunar valve development

“…Heart valve defects, including bicuspid aortic valve (BAV), represent the most prevalent class of congenital heart malformations, affecting 1%-5% newborns (Hoffman and Kaplan, 2002;Howard et al, 2019;Lupo et al, 2019). Moreover, heart valve disease is becoming more common among an aging global population (Rostagno, 2019).…”

Bioprosthetic Aortic Valve Replacement in <50 Years Old Patients – Where is the Evidence?

“…In BAV, valve sclerosis begins when patients are in their twenties. It is known that bicuspid is more prone to stenosis progression compared to tricuspid normal valves [7] . Calcium deposition sets during the fourth decade of life.…”