Causes, Diagnosis, Risk Stratification and Treatment of Bicuspid Aortic Valve Disease: An Updated Review

Sakellaropoulos, Stefanos; Mohammed, Muhemin; Svab, Stefano; Lekaditi, Dimitra; Sakellaropoulos, Panagiotis; Mitsis, Andreas

doi:10.14740/cr1061

Cited by 8 publications

(6 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bicuspid aortic valve (BAV) anatomy is the most common congenital cardiac condition, affecting 1-2% of the general population. In addition, BAV (both type 0 and I combined) is frequently associated with concomitant aortic pathology, including stenosis, regurgitation, aortopathy, and aortic dissection [71]. Traditionally, SAVR is the first-choice treatment for cases of BAV with valvular dysfunction requiring treatment.…”

Section: Patients With Bicuspid Aortic Valvementioning

confidence: 99%

Personalised Treatment in Aortic Stenosis: A Patient-Tailored Transcatheter Aortic Valve Implantation Approach

Mitsis

Yuan

Eftychiou

et al. 2022

JCDD

Self Cite

View full text Add to dashboard Cite

Transcatheter aortic valve replacement (TAVI) has become a game changer in the management of severe aortic stenosis shifting the concept from inoperable or high-risk patients to intermediate or low surgical-risk individuals. Among devices available nowadays, there is no clear evidence that one device is better than the other or that one device is suitable for all patients. The selection of the optimal TAVI valve for every patient represents a challenging process for clinicians, given a large number of currently available devices. Consequently, understanding the advantages and disadvantages of each valve and personalising the valve selection based on patient-specific clinical and anatomical characteristics is paramount. This review article aims to both analyse the available devices in the presence of specific clinical and anatomic features and offer guidance to select the most suitable valve for a given patient.

show abstract

Section: Patients With Bicuspid Aortic Valvementioning

confidence: 99%

Personalised Treatment in Aortic Stenosis: A Patient-Tailored Transcatheter Aortic Valve Implantation Approach

Mitsis

Yuan

Eftychiou

et al. 2022

JCDD

Self Cite

View full text Add to dashboard Cite

show abstract

“…3 Additionally, up to one-third of patients undergoing aortic valve replacement may also require aortic root surgery. 4 The advent of sutureless and rapid-deployment valves has facilitated surgery for patients who would otherwise not be a surgical candidate due to frailty or prolonged surgical procedures. Sutureless valves (Perceval Sorin [LivaNova group] Sutureless Aortic Heart Valve [Perceval]) consist of three biological pericardial leaflets mounted within a self-expanding Nitinol frame.…”

Section: Introductionmentioning

confidence: 99%

“…The need for surgery of the aortic valve and/or aorta is increased in patients with BAV, with one study showing a 27% incidence of a surgical event over a 20‐year period 3 . Additionally, up to one‐third of patients undergoing aortic valve replacement may also require aortic root surgery 4 …”

Section: Introductionmentioning

confidence: 99%

The use of sutureless and rapid‐deployment aortic valve prosthesis in patients with bicuspid aortic valve: A focused review

King

Stambulic

Payne

et al. 2022

Journal of Cardiac Surgery

View full text Add to dashboard Cite

Objective: The objective of this scoping review is to describe the postoperative outcomes and complications of patients with bicuspid aortic valve (BAV) treated with sutureless or rapid-deployment prosthesis.Background: The use of sutureless and rapid-deployment prostheses is generally avoided in patients with BAV due to anatomical concerns and the elevated risk of para-prosthetic leaks. Multiple studies have reported the use of these prostheses into patients with BAV with varying degrees of success. The focus of this review is to consolidate the current available evidence on this topic.Methods: A scoping review was conducted using a comprehensive search strategy in multiple databases (Medline, Embase, Cochrane Central Register of Controlled Clinical Trials) for relevant articles. All abstracts and full texts were screened by two independent reviewers according to predefined inclusion and exclusion criteria.Thirteen articles, including case reports and case series were ultimately included for analysis.Results: Of 1052 total citations, 44 underwent full text review and 13 (4 case reports, 6 retrospective analyses, and 3 prospective analyses) were included in the scoping review. Across all 13 studies, a total of 314 patients with BAV were used for data analysis. In sutureless and rapid-deployment prostheses, the mean postoperative aortic valvular gradients were less than 15 mmHg in all studies with mean postoperative aortic valvular areas all greater than 1.3 cm. 2 There were 186 total complications for an overall complication rate of 59%. Individual complications included new onset atrial fibrillation (n = 65), required pacemaker insertion (n = 24), intraprosthetic aortic regurgitation (n = 20), new onset atrioventricular block (n = 18), and new onset paravalvular leakage (n = 10).Conclusions: The use of sutureless and rapid deployment prostheses in patients with BAV showed comparable intraoperative and implantation success rates to patients without BAV. Postoperative complications from using these prostheses in patients with BAV included new onset atrial fibrillation, intraprosthetic aortic regurgitation, new onset atrioventricular block, and required pacemaker insertion. Various

show abstract

“…The heart valves of healthy people are composed of valve endothelial cells (VECs), valve interstitial cells (VICs), and extracellular matrix (ECM). VECs cover the valve surface, contact with blood, and maintain valve homeostasis by regulating permeability and inflammatory cell adhesion [ 6 , 7 ]. VECs participate in heart valve formation through EndMT: endothelial to mesenchymal transformation [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Identification of recurrent variants implicated in disease in bicuspid aortic valve patients through whole-exome sequencing

et al. 2022

View full text Add to dashboard Cite

Bicuspid aortic valve (BAV) is the most common congenital heart defect in human beings, with an estimated prevalence in the general population of between 0.5 and 2%. Moreover, BAV is the most common cause of aortic stenosis in the pediatric population. Patients with BAV may have no symptoms for life, and some of them may progress to aortic stenosis. Genetic factors increase the susceptibility and development of BAV. However, the pathogenesis and BAV are still unclear, and more genetic variants are still needed for elucidating the molecular mechanism and stratification of patients. The present study carried out screening of variants implicated in disease in BAV patients. The whole-exome sequencing (WES) was performed in 20 BAV patients and identified 40 different heterozygous missense mutations in 36 genes (MIB2, FAAH, S100A1, RGS16, MAP3K19, NEB, TTN, TNS1, CAND2, CCK, KALRN, ATP10D, SLIT3, ROS1, FABP7, NUP205, IL11RA, NPR2, COL5A1, CUBN, JMJD1C, ANXA7, TRIM8, LGR4, TPCN2, APOA5, GPR84, LRP1, NCOR2, AKAP11, ESRRB, NGB, AKAP13, WWOX, KCNJ12, ARHGEF1). The mutations in these genes were identified as recurrent variants implicated in disease by in silico prediction tool analysis. Nine genes (MIB2, S100A1, TTN, CCK, NUP205, LGR4, NCOR2, ESRRB, and WWOX) among the 36 genes were identified as variants implicated in disease via unanimous agreement of in silico prediction tool analysis and sequenced in an independent cohort of 137 BAV patients to validate the results of WES. BAV patients carrying these variants demonstrated reduced left ventricular ejection fractions (LVEF) (63.8 ± 7.5% vs. 58.4 ± 5.2%, P < 0.001) and larger calcification volume [(1129.3 ± 154) mm3 vs. (1261.8 ± 123) mm3, P < 0.001]. The variants in TTN, NUP205 and NCOR2 genes are significantly associated with reduced LVEF, and the variants in S100A1, LGR4, ESRRB, and WWOX genes are significantly associated with larger calcification volume. We identified a panel of recurrent variants implicated in disease in genes related to the pathogenesis of BAV. Our data speculate that these variants are promising markers for risk stratification of BAV patients with increased susceptibility to aortic stenosis.

show abstract

Causes, Diagnosis, Risk Stratification and Treatment of Bicuspid Aortic Valve Disease: An Updated Review

Cited by 8 publications

References 51 publications

Personalised Treatment in Aortic Stenosis: A Patient-Tailored Transcatheter Aortic Valve Implantation Approach

Personalised Treatment in Aortic Stenosis: A Patient-Tailored Transcatheter Aortic Valve Implantation Approach

The use of sutureless and rapid‐deployment aortic valve prosthesis in patients with bicuspid aortic valve: A focused review

Identification of recurrent variants implicated in disease in bicuspid aortic valve patients through whole-exome sequencing

Contact Info

Product

Resources

About