Valvular Heart Disease: Diagnosis and Management

Abstract

Valvular heart disease (VHD) encompasses a number of common cardiovascular conditions that account for 10% to 20% of all cardiac surgical procedures in the United States. A better understanding of the natural history coupled with the major advances in diagnostic imaging, interventional cardiology, and surgical approaches have resulted in accurate diagnosis and appropriate selection of patients for therapeutic interventions. A thorough understanding of the various valvular disorders is important to aid in the management of patients with VHD. Appropriate work-up for patients with VHD includes a thorough history for evaluation of causes and symptoms, accurate assessment of the severity of the valvular abnormality by examination, appropriate diagnostic testing, and accurate quantification of the severity of valve dysfunction and therapeutic interventions, if necessary. It is also important to understand the role of the therapeutic interventions vs the natural history of the disease in the assessment of outcomes. Prophylaxis for infective endocarditis is no longer recommended unless the patient has a history of endocarditis or a prosthetic valve.

Calcification of the Aortic Valve: the Arrival Point of a Complex Degenerative Process

“…[32][33][34][35] In case of bicuspid aortic valve, some histopathological aspects of the calcified aortic valve have been considered analogous to those found in thoracic aortic aneurysms or dissections and common pathogenic mechanisms have been demonstrated. 36,37 From a clinical point of view, we can consider the process of calcification of the aortic valve, above described, as a distinct pathology, independent from other infectious or immunological conditions. http://www.researchpub.org/journal/jcvd/jcvd.html However, we underline that pathogenic factors are common between calcification of the aortic valve and thoracic aortic aneurysm: the two diseases can appear simultaneously or, in other cases, successively one to other.…”

Expression of the Frizzled receptors and their co-receptors in calcified human aortic valves

“…It is mainly caused by aortic valve calcification (AVC) and is a progressive disease that is currently incurable (Lindman et al 2013;Maganti et al 2010). AVC is an active process involving basement membrane disruption, inflammatory and immune cell infiltration, and lipid deposition (Leopold 2012;Li et al 2013;Merryman and Schoen 2013).…”

Cleft-Like Formation of the Aortic Valve in an Adult Patient with a Single Coronary Artery

“…Aortic regurgitation (AR) can arise due to abnormalities in the aortic leaflets (e.g., infective endocarditis, congenital bicuspid valve, rheumatic valve, floppy valve), the aortic root and annulus (e.g., syphilis, Marfan's dissection), or both (e.g., ankylosing spondylitis), and from disease affecting neither the aorta nor the valve (e.g., ventricular septal defect, systemic hypertension) (1)(2)(3)(4)(5)(6)(7)(8)(9). Abnormalities of the aortic cusps leading to AR include congenital leaflet abnormalities, such as bicuspid, unicuspid, or quadricuspid valves, or rupture of a congenitally fenestrated valve (9).…”