International consensus statement on nomenclature and classification of the congenital bicuspid aortic valve and its aortopathy, for clinical, surgical, interventional and research purposes

Michelena, Héctor I.; Corte, Alessandro Della; Evangelista, Arturo; Maleszewski, Joseph J.; Edwards, William D.; Roman, Mary J.; Devereux, Richard B.; Fernández, Borja; Asch, Federico M.; Barker, Alex J.; Sierra-Galan, Lilia M.; Kerchove, Laurent de; Fernandes, Susan M.; Fedak, Paul W.M.; Girdauskas, Evaldas; Delgado, Victoria; Abbara, Suhny; Lansac, Emmanuel; Prakash, Siddharth K.; Bissell, Malenka M.; Popescu, Bogdan A; Hope, Michael D.; Sitges, Marta; Thourani, Vinod H.; Pibarot, Phillippe; Chandrasekaran, Krishnaswamy; Lancellotti, Patrizio; Borger, Michael A.; Forrest, John K.; Webb, John G.; Milewicz, Dianna M.; Makkar, Raj; Leon, Martin B.; Sanders, Stephen P.; Markl, Michael; Ferrari, Victor A.; Roberts, William C.; Song, Jae Kwan; Blanke, Philipp; White, Charles S.; Siu, Samuel C.; Svensson, Lars; Braverman, Alan C.; Bavaria, Joseph E.; Sundt, Thoralf M.; Khoury, Gébrine El; Paulis, Ruggero De; Enríquez-Sarano, Maurice; Bax, Jeroen J.; Otto, Catherine M.; Schäfers, Hans Joachim

doi:10.1016/j.jtcvs.2021.06.019

Cited by 58 publications

(44 citation statements)

References 129 publications

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“…While AI is present in approximately 30% of BAV patients, AS is much more common. Furthermore, over half of patients with BAV develop aortic dilatation and this may progress to aneurysm, dissection, and rupture, which are frequently lethal complications (49). Although BAV can cause morbidity and mortality through valvular disease and bicuspid aortopathy, the overall survival for patients with a BAV is similar to that of the non-BAV population (57).…”

Section: Clinical Significance Of Bav and Bicuspid Aortopathymentioning

confidence: 99%

“…The clinical manifestation of BAV-associated complications is heterogenous, spanning from some patients developing deadly aortic dilatation and subsequent dissection, and others suffering no symptoms at all (49). Various studies have quantified the risk over time of developing an aneurysm in the ascending aorta in BAV patients.…”

Section: Clinical Significance Of Bav and Bicuspid Aortopathymentioning

confidence: 99%

“…Numerous factors affect rate of aortic dilatation in BAV. Different studies have shown that aortic wall shear stress (WSS) is a major factor associated with ascending aorta growth (49,81,87). Normally, physiologic WSS decreases with age (88).…”

Section: Clinical Implications Of Bicuspid Aortopathymentioning

confidence: 99%

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Clinical implications of the biomechanics of bicuspid aortic valve and bicuspid aortopathy

Hassanabad

King

Martino

et al. 2022

Front. Cardiovasc. Med.

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Bicuspid aortic valve (BAV), which affects up to 2% of the general population, results from the abnormal fusion of the cusps of the aortic valve. Patients with BAV are at a higher risk for developing aortic dilatation, a condition known as bicuspid aortopathy, which is associated with potentially life-threatening sequelae such as aortic dissection and aortic rupture. Although BAV biomechanics have been shown to contribute to aortopathy, their precise impact is yet to be delineated. Herein, we present the latest literature related to BAV biomechanics. We present the most recent definitions and classifications for BAV. We also summarize the current evidence pertaining to the mechanisms that drive bicuspid aortopathy. We highlight how aberrant flow patterns can contribute to the development of aortic dilatation. Finally, we discuss the role cardiac magnetic resonance imaging can have in assessing and managing patient with BAV and bicuspid aortopathy.

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Section: Clinical Significance Of Bav and Bicuspid Aortopathymentioning

confidence: 99%

Section: Clinical Significance Of Bav and Bicuspid Aortopathymentioning

confidence: 99%

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Clinical implications of the biomechanics of bicuspid aortic valve and bicuspid aortopathy

Hassanabad

King

Martino

et al. 2022

Front. Cardiovasc. Med.

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“…De Kerchove et al suggested a classification system assessing the surgical repairability of the BAV, such as commissural orientation (varying from symmetrical to very asymmetrical cusp angles), length of fusion, and non-functional commissure height ( 12 ). Very recently, a new international consensus statement on the nomenclature of BAV has been developed with a simple and comprehensive classification system based on imaging modalities (echocardiographic, CT, and MRI) and anatomical surgical pathology ( Figure 1 ) ( 13 ). The authors described 3 types of BAV: the fused (similar to Sievers type 1), the 2-sinus (latero-lateral and antero-posterior phenotypes), and the partial-fusion types.…”

Section: Nomenclaturementioning

confidence: 99%

Bicuspid Aortic Valve Stenosis: From Pathophysiological Mechanism, Imaging Diagnosis, to Clinical Treatment Methods

Perrin

Ibrahim

Dürrleman

et al. 2022

Front. Cardiovasc. Med.

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Bicuspid aortic valve (BAV) is the most frequent congenital anomaly and has a natural evolution toward aortic regurgitation or stenosis due to the asymmetrical valve function associated with an evolutive ascending aortopathy. Several BAV classifications exist describing the presence and number of raphe, amount and location of calcium, and the symmetry of the functional cusps. The impact of BAV morphology on transcatheter aortic valve implantation (TAVI) outcomes still remains little investigated. Pivotal randomized trials comparing TAVI with surgery have excluded BAV until yet. However, data from registries and observational studies including highly selected patients have shown promising results of TAVI in BAV. With this review, we aimed at describing anatomical and pathophysiological characteristics of BAV, discussing the main aspects to assess diagnostic imaging modalities, and giving an overview of TAVI outcomes and technical considerations specific to BAV morphology.

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“…Due to the complexity of both pathologies and their association with each other, a clear nomenclature is mandatory to speak with the same language and to compare results with other centers. With regard to BAV, a recent international consensus paper on the nomenclature, classification of BAV and its associated aortopathy has been published ( 6 ). This document should act as a basis for patient evaluation and decision making.…”

mentioning

confidence: 99%

The aortic team and bicuspid aortic valve patients

Misfeld¹,

Etz²,

Leontyev³

et al. 2022

Ann Cardiothorac Surg

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International consensus statement on nomenclature and classification of the congenital bicuspid aortic valve and its aortopathy, for clinical, surgical, interventional and research purposes

Cited by 58 publications

References 129 publications

Clinical implications of the biomechanics of bicuspid aortic valve and bicuspid aortopathy

Clinical implications of the biomechanics of bicuspid aortic valve and bicuspid aortopathy

Bicuspid Aortic Valve Stenosis: From Pathophysiological Mechanism, Imaging Diagnosis, to Clinical Treatment Methods

The aortic team and bicuspid aortic valve patients

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