title: Advances in the treatment of aortic valve disease: is it time for companion diagnostics?
abstract: OBJECTIVE
  Aortic valve disease (AVD) is a growing public health problem, and the pathogenesis underlying AVD is complex. The lack of durable bioprostheses and pharmacologic therapies remain central needs in care. The purpose of this review is to highlight recent clinical studies that impact the care of children with AVD and is to explore ongoing translational research efforts.
  
  
  RESULTS
  Clinical studies have evaluated the durability of bioprosthetics and surgical strategies, tested statins during early disease, and identified new predictive biomarkers. Large animal models have demonstrated the effectiveness of a novel bioprosthetic scaffold. Mouse models of latent AVD have advanced our ability to elucidate natural history and perform preclinical studies that test new treatments in the context of early disease.
  
  
  CONCLUSIONS
  Current priorities for AVD patients include identifying new pharmacologic treatments and developing durable bioprostheses. Multidisciplinary efforts are needed that bridge pediatric and adult programs, and bring together different types of expertise and leverage network and consortium resources. As our understanding of the underlying complex genetics is better defined, companion diagnostics may transform future clinical trials and ultimately improve the care of patients with AVD by promoting personalized medicine and early intervention.
authors.affiliation: Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Hinton
mesh_terms: D000818:Animals; D001021:Aortic Valve / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D001705:Bioprosthesis; D002648:Child; D004195:Disease Models, Animal; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000601:surgery; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000639:trends; D006801:Humans; D051379:Mice; D020380:Needs Assessment; D057285:Precision Medicine / Q000639:trends*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011634:Public Health; D057170:Translational Research, Biomedical
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