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Aorta bicuspide

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https://www.readbyqxmd.com/read/28086801/two-dimensional-speckle-tracking-echocardiography-for-evaluation-of-dilative-ascending-aorta-biomechanics
#1
Monika Bieseviciene, Jolanta Justina Vaskelyte, Vaida Mizariene, Rasa Karaliute, Vaiva Lesauskaite, Raimonda Verseckaite
BACKGROUND: Two-dimensional (2D) echocardiography is one of the most feasible, noninvasive methods for assessing the aortic diameter and biomechanical changes. We studied possible interfaces between noninvasive biomechanical and speckle-tracking (ST) echocardiographic data from dilated aortas. METHODS: Altogether, 44 patients with dilative pathology of ascending aorta (DPAA) were compared with subjects without ascending aortic dilation (diameter <40 mm). DPAA patients formed two groups based on diameter size: group 1, ≤45 mm diameter; group 2, >45 mm...
January 13, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28052146/prognostic-implications-of-raphe-in-bicuspid-aortic-valve-anatomy
#2
William K F Kong, Victoria Delgado, Kian Keong Poh, Madelien V Regeer, Arnold C T Ng, Louise McCormack, Tiong Cheng Yeo, Miriam Shanks, Sarah Parent, Roxana Enache, Bogdan A Popescu, Michael Liang, James W Yip, Lawrence C W Ma, Vasileios Kamperidis, Philippe J van Rosendael, Enno T van der Velde, Nina Ajmone Marsan, Jeroen J Bax
Importance: Little is known about the association between bicuspid aortic valve (BAV) morphologic findings and the degree of valvular dysfunction, presence of aortopathy, and complications, including aortic valve surgery, aortic dissection, and all-cause mortality. Objective: To investigate the association between BAV morphologic findings (raphe vs nonraphe) and the degree of valve dysfunction, presence of aortopathy, and prognosis (including need for aortic valve surgery, aortic dissection, and all-cause mortality)...
January 4, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28034902/risk-factors-for-coarctation-of-the-aorta-on-prenatal-ultrasound-a-systematic-review-and-meta-analysis
#3
Alessandra Familiari, Maddalena Morlando, Asma A Khalil, Sonesson Sven-Erik, Carolina Scala, Giuseppe Rizzo, Gelsomina Del Sordo, Chiara Vassallo, Maria Elena Flacco, Lamberto Manzoli, Antonio Lanzone, Giovanni Scambia, Ganesh Acharya, Francesco D'Antonio
BACKGROUND: -Prenatal diagnosis of Coarctation of the Aorta (CoA) is still challenging and affected by high rates of false positive diagnoses. The aim of this study was to ascertain the strength of association and to quantify the diagnostic accuracy of different ultrasound signs in predicting CoA prenatally. METHODS: -Medline, Embase, CINAHL and Cochrane databases were searched. Random-effect and HSROC model meta-analyses were used to analyse the data. RESULTS: -794 articles were identified and 12 (922 fetuses at risk for CoA) were included...
December 29, 2016: Circulation
https://www.readbyqxmd.com/read/28033264/clinical-and-echocardiographic-determinants-in-bicuspid-aortic-dilatation-results-from-a-longitudinal-observational-study
#4
Frederique E C M Peeters, Noreen Van der Linden, Alissa L L Thomassen, Harry J G M Crijns, Steven J R Meex, Bas L J H Kietselaer
Bicuspid aortic valve (BAV) disease is associated with aortic dilatation. Timing of follow-up and surgery is challenging. Hence, there is an unmet clinical need for additional risk stratification. It is unclear whether valve morphology is associated with dilatation rates. Therefore, the objective of this study was to examine the association between clinical and echocardiographic determinants (including valve morphology) and aortic dimension and the progression rate of dilatation.Aortic dimensions were assessed on serial echocardiographic images between 1999 and 2014 in a population of 392 patients with BAVs in a tertiary care center in the Netherlands...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27989994/functional-assessment-of-thoracic-aortic-aneurysms-the-future-of-risk-prediction
#5
REVIEW
Pouya Youssefi, Rajan Sharma, C Alberto Figueroa, Marjan Jahangiri
INTRODUCTION: Treatment guidelines for the thoracic aorta concentrate on size, yet acute aortic dissection or rupture can occur when aortic size is below intervention criteria. Functional imaging and computational techniques are a means of assessing haemodynamic parameters involved in aortic pathology. SOURCES OF DATA: Original articles, reviews, international guidelines. AREAS OF AGREEMENT: Computational fluid dynamics and 4D flow MRI allow non-invasive assessment of blood flow parameters and aortic wall biomechanics...
December 17, 2016: British Medical Bulletin
https://www.readbyqxmd.com/read/27989036/ascending-aortic-stiffness-with-bicuspid-aortic-valve-is-variable-and-not-predicted-by-conventional-parameters-in-young-patients
#6
Nicholas S Burris, Petter Dyverfeldt, Michael D Hope
BACKGROUND: Bicuspid aortic valve (BAV)-related aortopathy is characterized by histological abnormalities that result in aortic wall stiffening and aortic dilation. The study aim was to determine the range of ascending aortic stiffness seen in a clinical cohort of patients with BAV, and to identify the association of aortic stiffness with standard clinical and imaging parameters. METHODS: Patients with BAV (n = 65) and normal subjects (n = 10) were studied using conventional phase-contrast magnetic resonance imaging through the ascending aorta...
May 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27989035/aortopathy-in-bicuspid-aortic-valve-stenosis-with-fusion-of-right-left-versus-right-non-coronary-cusps-are-these-different-diseases
#7
Evaldas Girdauskas, Mina Rouman, Kushtrim Disha, Georg Dubslaff, Beatrix Fey, Bernhard Theis, Iver Petersen, Michael A Borger, Yskert von Kodolitsch, Thomas Kuntze, Hermann Reichenspurner
BACKGROUND: The study aim was to prospectively analyze the impact of cusp fusion pattern on aortopathy severity in patients undergoing surgery for bicuspid aortic valve (BAV) stenosis. METHODS: A total of 137 consecutive patients with BAV stenosis (93 males, 44 females; mean age 61 ± 9 years) underwent aortic valve replacement with or without concomitant aortic surgery between January 2012 and March 2015. All patients underwent preoperative cardiac magnetic resonance imaging (cMRI) in order to evaluate morphological/functional parameters of the aortic root...
May 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27965921/clinical-implication-of-aortic-wall-biopsy-in-aortic-valve-disease-with-bicuspid-valve-pathology
#8
Yong Han Kim, Ji Seong Kim, Jae-Woong Choi, Hyoung Woo Chang, Kwon Joong Na, Jun Sung Kim, Kyung-Hwan Kim
BACKGROUND: Although unique aortic pathology related to bicuspid aortic valve (BAV) has been previously reported, clinical implications of BAV to aortopathy risk have yet to be investigated. We looked for potential differences in matrix protein expressions in the aortic wall in BAV patients. METHODS: Aorta specimens were obtained from 31 patients: BAV group (n=27), tricuspid aortic valve (TAV) group (n=4). The BAV group was categorized into three subgroups: left coronary sinus-right coronary sinus (R+L group; n=13, 42%), right coronary sinus-non-coronary sinus (R+N group; n=8, 26%), and anteroposterior (AP group; n=6, 19%)...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27956040/shone-complex-an-under-recognized-congenital-heart-disease-with-substantial-morbidity-in-adulthood
#9
Sajid Aslam, Paul Khairy, Azadeh Shohoudi, Lise-Andrée Mercier, Annie Dore, François Marcotte, Joaquim Miró, Pablo Avila-Alonso, Réda Ibrahim, Anita Asgar, Nancy Poirier, François-Pierre Mongeon
BACKGROUND: Shone complex consists of a constellation of left-sided, usually obstructive, cardiac lesions, including supravalvar mitral ring, parachute mitral valve, subaortic stenosis, and aortic coarctation. Incomplete Shone complex consists of a mitral valve anomaly associated with lesions involving the subaortic region, aortic valve, or thoracic aorta. There is a paucity of data regarding long-term outcomes in adults with Shone complex. METHODS: We reviewed records of adults with complete or incomplete Shone complex followed at the Montreal Heart Institute between 1982 and 2014...
September 29, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27955909/cardiovascular-operations-for-loeys-dietz-syndrome-intermediate-term-results
#10
Nishant D Patel, Todd Crawford, J Trent Magruder, Diane E Alejo, Narutoshi Hibino, James Black, Harry C Dietz, Luca A Vricella, Duke E Cameron
OBJECTIVES: Early experience with Loeys-Dietz syndrome (LDS) suggested an aggressive aortopathy with high risk of aneurysm dissection and rupture at young ages and at smaller aortic diameters than in other connective tissue disorders. We reviewed our experience with LDS to re-examine our indications and outcomes of surgical management. METHODS: We reviewed all patients with a diagnosis of LDS who underwent cardiovascular surgery at our institution. The primary endpoint was mortality, and secondary endpoints included postoperative complications and need for reintervention...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27939432/regulation-of-microrna-expression-in-vascular-smooth-muscle-by-mrtf-a-and-actin-polymerization
#11
Azra Alajbegovic, Karolina M Turczyńska, Tran Thi Hien, Pilar Cidad, Karl Swärd, Per Hellstrand, Alessandro Della Corte, Amalia Forte, Sebastian Albinsson
The dynamic properties of the actin cytoskeleton in smooth muscle cells play an important role in a number of cardiovascular disease states. The state of actin does not only mediate mechanical stability and contractile function but can also regulate gene expression via myocardin related transcription factors (MRTFs). These transcriptional co-activators regulate genes encoding contractile and cytoskeletal proteins in smooth muscle. Regulation of small non-coding microRNAs (miRNAs) by actin polymerization may mediate some of these effects...
December 8, 2016: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27938448/bicuspid-aortic-valve-outcomes
#12
Inês Rodrigues, Ana F Agapito, Lídia de Sousa, José A Oliveira, Luísa M Branco, Ana Galrinho, João Abreu, Ana T Timóteo, Sílvia A Rosa, Rui C Ferreira
BACKGROUND: Bicuspid aortic valve is the most common CHD. Its association with early valvular dysfunction, endocarditis, thoracic aorta dilatation, and aortic dissection is well established. OBJECTIVE: The aim of this study was to assess the incidence and predictors of cardiac events in adults with bicuspid aortic valve. METHODS: We carried out a retrospective analysis of cardiac outcomes in ambulatory adults with bicuspid aortic valve followed-up in a tertiary hospital centre...
December 12, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27893194/incidence-morphology-and-progression-of-bicuspid-aortic-valve-in-pediatric-and-young-adult-subjects-with-coexisting-congenital-heart-defects
#13
Talha Niaz, Joseph T Poterucha, Jonathan N Johnson, Cecilia Craviari, Thomas Nienaber, Jared Palfreeman, Frank Cetta, Donald J Hagler
BACKGROUND: Bicuspid aortic valve (BAV) occurs both as an isolated cardiac lesion and in association with congenital heart defects (CHD). Their aim was to identify the incidence and morphology of BAV in patients with coexisting CHD and compare their disease progression to patients with isolated BAV. METHODS: The Mayo Clinic echocardiography database was retrospectively analyzed to identify pediatric and young adult patients (≤22 years) who were diagnosed with BAV from 1990 to 2015...
November 28, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27866026/survival-and-cardiovascular-events-after-coarctation-repair-in-long-term-follow-up-coafu-predictive-value-of-clinical-variables
#14
P Bambul Heck, J Pabst von Ohain, H Kaemmerer, P Ewert, A Hager
OBJECTIVE: Long-term sequelae and events after coarctation repair are well described. However, the predictive value of variables from clinical follow-up investigation for late events and survival has rarely been investigated. METHODS: All patients who participated in the prospective cross-sectional COALA Study in 2000 with a structural clinical investigation including blood pressure measurement and symptom-limited exercise test were contacted for reevaluation of survival, current clinical status and major cardiovascular events...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27863744/towards-the-improved-quantification-of-in-vivo-abnormal-wall-shear-stresses-in-bav-affected-patients-from-4d-flow-imaging-benchmarking-and-application-to-real-data
#15
F Piatti, S Pirola, M Bissell, I Nesteruk, F Sturla, A Della Corte, A Redaelli, E Votta
Bicuspid aortic valve (BAV), i.e. the fusion of two aortic valve cusps, is the most frequent congenital cardiac malformation. Its progression is often characterized by accelerated leaflet calcification and aortic wall dilation. These processes are likely enhanced by altered biomechanical stimuli, including fluid-dynamic wall shear stresses (WSS) acting on both the aortic wall and the aortic valve. Several studies have proposed the exploitation of 4D-flow magnetic resonance imaging sequences to characterize abnormal in vivo WSS in BAV-affected patients, to support prognosis and timing of intervention...
January 4, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/27861233/aortic-volumetry-at-contrast-enhanced-magnetic-resonance-angiography-feasibility-as-a-sensitive-method-for-monitoring-bicuspid-aortic-valve-aortopathy
#16
Brian Trinh, Iram Dubin, Ozair Rahman, Marcos P Ferreira Botelho, Nicholas Naro, James C Carr, Jeremy D Collins, Alex J Barker
OBJECTIVES: Bicuspid aortic valve patients can develop thoracic aortic aneurysms and therefore require serial imaging to monitor aortic growth. This study investigates the reliability of contrast-enhanced magnetic resonance angiography (CEMRA) volumetry compared with 2-dimensional diameter measurements to identify thoracic aortic aneurysm growth. MATERIALS AND METHODS: A retrospective, institutional review board-approved, and Health Insurance Portability and Accountability Act-compliant study was conducted on 20 bicuspid aortic valve patients (45 ± 8...
November 17, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27855987/simulations-of-morphotype-dependent-hemodynamics-in-non-dilated-bicuspid-aortic-valve-aortas
#17
Kai Cao, Samantha K Atkins, Andrew McNally, Janet Liu, Philippe Sucosky
Bicuspid aortic valves (BAVs) generate flow abnormalities that may promote aortopathy. While positive helix fraction (PHF) index, flow angle (θ), flow displacement (d) and wall shear stress (WSS) exhibit abnormalities in dilated BAV aortas, it is unclear whether those anomalies stem from the abnormal valve anatomy or the dilated aorta. Therefore, the objective of this study was to quantify the early impact of different BAV morphotypes on aorta hemodynamics prior to dilation. Fluid-structure interaction models were designed to quantify standard peak-systolic flow metrics and temporal WSS characteristics in a realistic non-dilated aorta connected to functional tricuspid aortic valve (TAV) and type-I BAVs...
January 4, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/27847162/patient-specific-computational-fluid-dynamics-assessment-of-aortic-hemodynamics-in-a-spectrum-of-aortic-valve-pathologies
#18
Pouya Youssefi, Alberto Gomez, Taigang He, Lisa Anderson, Nick Bunce, Rajan Sharma, C Alberto Figueroa, Marjan Jahangiri
OBJECTIVES: The complexity of aortic disease is not fully exposed by aortic dimensions alone, and morbidity or mortality can occur before intervention thresholds are met. Patient-specific computational fluid dynamics (CFD) were used to assess the effect of different aortic valve morphologies on velocity profiles, flow patterns, helicity, wall shear stress (WSS), and oscillatory shear index (OSI) in the thoracic aorta. METHODS: A total of 45 subjects were divided into 5 groups: volunteers, aortic regurgitation-tricuspid aortic valve (AR-TAV), aortic stenosis-tricuspid aortic valve (AS-TAV), aortic stenosis-bicuspid aortic valve right-left cusp fusion (BAV[RL]), and aortic stenosis-right-non cusp fusion (AS-BAV[RN])...
January 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27793403/long-term-results-following-pericardial-patch-augmentation-for-incompetent-bicuspid-aortic-valves-a-single-center%C3%A2-experience
#19
Marlene Thudt, Nestoras Papadopoulos, Nadejda Monsefi, Aleksandra Miskovic, Afsaneh Karimian-Tabrizi, Andreas Zierer, Anton Moritz
BACKGROUND: Many techniques for repair of bicuspid aortic valves have been described and long-term results differ considerably. The current study evaluates our institutional results using the pericardial patch augmentation technique with the aim of increasing coaptation height. METHODS: From November 2002 through April 2015, 103 consecutive patients underwent aortic valve repair using pericardial patch augmentation for incompetent bicuspid aortic valve. Of them 26 were referred with an aortic valve regurgitation grade 1+ or 2+ and were excluded from the current report...
October 25, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27779199/mesenchymal-state-of-intimal-cells-may-explain-higher-propensity-to-ascending-aortic-aneurysm-in-bicuspid-aortic-valves
#20
Shohreh Maleki, Sanela Kjellqvist, Valentina Paloschi, Joelle Magné, Rui Miguel Mamede Branca, Lei Du, Kjell Hultenby, Johan Petrini, Jonas Fuxe, Janne Lehtiö, Anders Franco-Cereceda, Per Eriksson, Hanna M Björck
Individuals with a bicuspid aortic valve (BAV) are at significantly higher risk of developing aortic complications than individuals with tricuspid aortic valves (TAV) and defective signaling during the embryonic development and/or life time exposure to abnormal hemodynamic have been proposed as underlying factors. However, an explanation for the molecular mechanisms of aortopathy in BAV has not yet been provided. We combined proteomics, RNA analyses, immunohistochemistry, and electron microscopy to identify molecular differences in samples of non-dilated ascending aortas from BAV (N = 62) and TAV (N = 54) patients...
October 25, 2016: Scientific Reports
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