title: Atrioventricular block as the initial presentation of calcified bicuspid aortic valve.
abstract: BACKGROUND
  Bicuspid aortic valve (BAV) is one of the most common and important congenital heart disorders in adults. If a patient with congenital disorders is not diagnosed early, the patient's disease may progress to a severe condition and thus diagnosis of the main disorder will be rendered difficult.
  
  
  METHODS
  A 34 year-old male patient referred to a referral medical care unit for cardiac electrophysiological study with cardiac shock due to complete heart block 3 months ago and he underwent Dual-Chamber permanent pacemaker (PPM) implantation. Thick and calcified bicuspid AV with invasion to interventricular septum, moderate to severe valve insufficiency (AI), severe aortic valve stenosis (AS), and dilated ascending aorta were observed at his echocardiography. Aortic valve replacement (AVR), aneurysm of ascending aorta, root replacement with tube graft (Bentall Procedure), and also a 3 chambers intracardiac defibrillator (ICD) were used. After 2 weeks of operation, he was discharged and at the first post-hospitalization visit (1 week later), his cardiovascular condition was acceptable.
  
  
  CONCLUSIONS
  Thick calcified aortic root is a less studied and potential contributing risk factor for AV block after AVR. Therefore, in candidates of aortic valve replacement, considering conductive disorders, especially in patients with calcified valve, is mandatory. Irreversible AV block requiring PPM implantation is a rare condition following AVR.
authors: Department of Cardiovascular Diseases, School of Medicine AND Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors: Reza
authors: R
authors: Karbasi-Afshar
authors: Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors: Nematollah
authors: N
authors: Jonaidi-Jafari
authors: Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors: Amin
authors: A
authors: Saburi
authors: Assistant Professor, Department of Cardiovascular Diseases, School of Medicine AND Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors: Arezoo
authors: A
authors: Khosravi
keywords: Atrioventricular Block; Bicuspid Aortic Valve; Calcified Valve