Relation of Coarctation of the Aorta to the Occurrence of Ascending Aortic Dilation in Children and Young Adults With Bicuspid Aortic Valves

Beaton, Andrea; Nguyen, Thieu; Lai, Wyman W.; Chatterjee, Samprit; Ramaswamy, Prema; Lytrivi, Irene D.; Parness, Ira A.; Srivastava, Shubhika

doi:10.1016/j.amjcard.2008.09.062

Cited by 36 publications

(23 citation statements)

References 23 publications

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“…2e5 Furthermore, agreeing with the published pediatric and adult data, children in the BAV group have larger aortic annular and ascending aortic dimensions. 4,28 In a subgroup analysis of children with BAV, we found that R-N morphology is associated with valve dysfunction, which agrees with previous studies. 2,4 Although there is a trend toward more eccentric AV annuli in patients with BAV with R-N morphology, this does not reach statistical significance (p ¼ 0.061).…”

Section: Discussionsupporting

confidence: 93%

Three-Dimensional Evaluation of Aortic Valve Annular Shape in Children With Bicuspid Aortic Valves and/or Aortic Coarctation Compared With Controls

Chamberland

Sugeng

Abraham

et al. 2015

The American Journal of Cardiology

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Section: Discussionsupporting

confidence: 93%

Three-Dimensional Evaluation of Aortic Valve Annular Shape in Children With Bicuspid Aortic Valves and/or Aortic Coarctation Compared With Controls

Chamberland

Sugeng

Abraham

et al. 2015

The American Journal of Cardiology

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“…Clinical observations revealed that the dimensions of the aortic root and ascending aorta were larger in patients with a bicuspid aortic valve than in those with a tricuspid aortic valve with either normally functioning aortic valve, or matched valvular lesions (aortic regurgitation, aortic stenosis, or mixed lesions), or with aortic dilation . Aortic‐wall abnormalities were frequent in adults with coarctation of the aorta, although the ascending aorta in the patients with a bicuspid aortic valve and coarctation of the aorta did not dilate to the same degree as in the patients with isolated bicuspid aortic valve . Immer et al have compared types A and B AoDs in pregnant women.…”

Section: Discussionmentioning

confidence: 99%

“…112 Aortic-wall abnormalities were frequent in adults with coarctation of the aorta, although the ascending aorta in the patients with a bicuspid aortic valve and coarctation of the aorta did not dilate to the same degree as in the patients with isolated bicuspid aortic valve. 113 Immer et al 1 have compared types A and B AoDs in pregnant women. In a total of 45 women with acute type A dissection and 12 with type B dissection in pregnancy, type A dissection that developed prepartum extended 48 mm in diameter, whereas the aortic dimensions of type B dissection were not measured.…”

Section: Discussionmentioning

confidence: 99%

Aortic Dissection During Pregnancy: A Difficult Clinical Scenario

Yuan

2013

Clinical Cardiology

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Aortic dissection (AoD) during pregnancy is a rare but lethal condition and highlights the need for extensive elucidation. The aim of this study is to reveal the risk factors for AoD during pregnancy and to compare the 2 main risk factors, Marfan syndrome and pregnancy itself in the previously healthy woman. The pregnant patients developed AoD at 31.7 ± 7.6 weeks of gestation. It occurred much earlier in the Marfan patients than in the previously healthy women (30.7 ± 8.6 weeks of gestation vs 34.4 ± 4.4 weeks of gestation, P = 0.0263). In the Marfan patients, AoD developed in 3 (3.2%), 15 (15.8%), and 43 (46.3%) patients in the 3 trimesters, respectively, compared with 31 of the previously healthy women, and only in the third trimester. The neonates of the Marfan patients had better Apgar scores at 1 and 5 minutes, lower intubation rates, and fewer stays in the neonatal intensive care unit than those of the previously healthy women. Marfan syndrome and pregnancy itself in the previously healthy woman were the 2 main risk factors responsible for the occurrence of AoD during pregnancy. Marfan patients may develop AoD at an early age and an early stage of pregnancy, probably due to the preexisting weakened aortic wall. Better outcomes for the surviving neonates of Marfan patients compared with neonates of the previously healthy women might be the result of the poor condition of Marfan patients causing a higher death rate for those fetuses.

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“…This structural alteration seems to be a consequence of an abnormal developmental process of the aortic cusps during embryogenesis [2–9]. …”

Section: Introductionmentioning

confidence: 99%

The Role of ECG-Gated CT in Patients with Bicuspid Aortic Valve Replacement: New Perspectives in Short- and Long-Term Followup

et al. 2013

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The aim of our study was to compare the results of the TTE (transthoracic echocardiography) with the results obtained by the ECG-gated 64 slices CT during the followup of patients with bicuspid aortic valve (BAV), after aortic valve replacement; in particular we evaluated the aortic root and the ascending aorta looking for a new algorithm in the followup of these patients. From January 1999 to December 2009 our attention was focused on 67 patients with isolated surgical substitution of aortic valve; after dismissal they were strictly observed. During the period between May and September 2010, these patients underwent their last evaluation, and clinical exams, ECG, TTE, and an ECG-gated-MDCT were performed. At followup TTE results showed an aortic root of 36.7 ± 4 mm and an ascending aorta of 39.6 ± 4.8 mm. ECG- gated CT showed an aortic root of 37.9 ± 5.5 mm and an ascending aorta of 43.1 ± 5.2. The comparison between preoperative and postoperative TTE shows a significant long-term dilatation of the ascending aorta while the aortic root diameter seems to be stable. ECG-gated CT confirms the stability of the aortic root diameter (38.2 ± 5.3 mm versus 37.9 ± 5.5 mm; <0.0001) and the increasing diameter value of the ascending aorta (40.2 ± 3.9 mm versus 43.1 ± 5.2 mm; P = 0.0156). Due to the different findings between CT and TTE studies, ECG-gated CT should no longer be considered as a complementary exam in the followup of patients with BAV, but as a fundamental role since it is a real necessity.

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Relation of Coarctation of the Aorta to the Occurrence of Ascending Aortic Dilation in Children and Young Adults With Bicuspid Aortic Valves

Cited by 36 publications

References 23 publications

Three-Dimensional Evaluation of Aortic Valve Annular Shape in Children With Bicuspid Aortic Valves and/or Aortic Coarctation Compared With Controls

Three-Dimensional Evaluation of Aortic Valve Annular Shape in Children With Bicuspid Aortic Valves and/or Aortic Coarctation Compared With Controls

Aortic Dissection During Pregnancy: A Difficult Clinical Scenario

The Role of ECG-Gated CT in Patients with Bicuspid Aortic Valve Replacement: New Perspectives in Short- and Long-Term Followup

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