Bicuspid aortic valve aortopathy: mechanistic and clinical insights from recent studies.
OBJECTIVE
This focused review summarizes key insights from the past 12 months of basic science and clinical research on bicuspid aortic valve (BAV)-associated aortopathy.


RESULTS
Recent studies in BAV-associated aortopathy support a heterogeneous spectrum of disease with distinct phenotypes. Basic science studies provide further support for the concept of regional differences in the severity of aortopathy within the aorta of BAV patients. Clinical studies compared outcomes of BAV patients after isolated aortic valve replacement and showed that those with primarily valvular insufficiency as compared with stenosis may be at greater risk for important aortic events over time. These novel insights will be important to optimize future aortic resection strategies and clinical practice guidelines.


CONCLUSIONS
As the most common congenital heart defect, BAV disease is a considerable health burden. Recent studies show differences in the clinical manifestation of disease patterns that may have important implications for future research and the evolution toward more patient-specific surgical practice guidelines.
aSection of Cardiac Surgery, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AlbertabDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael's Hospital, University of Toronto, Toronto, Ontario, CanadacMartha and Richard Melman Family Bicuspid Aortic Valve Program, Bluhm Cardiovascular Institute, Northwestern University, Chicago, Illinois, USA.
David G
DG
Guzzardi
Subodh
S
Verma
Paul W M
PW
Fedak
D001021:Aortic Valve / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D001027:Aortography / Q000379:methods*; D000082882:Bicuspid Aortic Valve Disease; D006349:Heart Valve Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D010641:Phenotype; D016896:Treatment Outcome