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Aorta bicuspide

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https://www.readbyqxmd.com/read/28203207/morphotype-dependent-flow-characteristics-in-bicuspid-aortic-valve-ascending-aortas-a-benchtop-particle-image-velocimetry-study
#1
Andrew McNally, Ashish Madan, Philippe Sucosky
The bicuspid aortic valve (BAV) is a major risk factor for secondary aortopathy such as aortic dilation. The heterogeneous BAV morphotypes [left-right-coronary cusp fusion (LR), right-non-coronary cusp fusion (RN), and left-non-coronary cusp fusion (LN)] are associated with different dilation patterns, suggesting a role for hemodynamics in BAV aortopathogenesis. However, assessment of this theory is still hampered by the limited knowledge of the hemodynamic abnormalities generated by the distinct BAV morphotypes...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28194732/late-post-avr-progression-of-bicuspid-aortopathy-link-to-hemodynamics
#2
Shiho Naito, Tatiana Gross, Kushtrim Disha, Yskert von Kodolitsch, Hermann Reichenspurner, Evaldas Girdauskas
BACKGROUND AND AIM OF THE STUDY: The ascending aortic dilatation may progress after aortic valve replacement (AVR) in bicuspid aortic valve (BAV) patients. Our aim was to evaluate rheological flow patterns and histological characteristics of the aneurysmal aorta in BAV patients at the time of reoperative aortic surgery. MATERIALS AND METHODS: 13 patients (mean age: 42 ± 9 years, 10 (77%) male) with significant progression of proximal aortopathy after isolated AVR surgery for BAV disease (i...
February 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28190607/patient-specific-assessment-of-hemodynamics-by-computational-fluid-dynamics-in-patients-with-bicuspid-aortopathy
#3
Naoyuki Kimura, Masanori Nakamura, Kenji Komiya, Satoshi Nishi, Atsushi Yamaguchi, Osamu Tanaka, Yoshio Misawa, Hideo Adachi, Koji Kawahito
OBJECTIVE: Hemodynamics related to eccentric blood flow may factor into the development of bicuspid aortic valve aortopathy. We investigated wall shear stress distribution by means of magnetic resonance imaging-based computational fluid dynamics in patients with a bicuspid aortic valve. METHODS: Included were 12 patients with a bicuspid aortic valve (aortic stenosis, n = 11; root enlargement, n = 1). Three patients with a normal tricuspid aortic valve (arch aneurysm, n = 1; descending aortic aneurysm, n = 2) were included for comparison...
January 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28185644/bicuspid-aortic-valve-morphotype-correlates-with-regional-antioxidant-gene%C3%A2-expression-profiles-in-the-proximal%C3%A2-ascending-aorta
#4
Julie A Phillippi, Jennifer C Hill, Marie Billaud, Benjamin R Green, Mary P Kotlarczyk, Thomas G Gleason
BACKGROUND: Bicuspid aortic valve (BAV) is associated with asymmetric dilatation of the proximal ascending aorta. We previously demonstrated increased susceptibility of smooth muscle cells to oxidative stress in the BAV-aneurysmal aorta and hypothesized that antioxidant expression is regionally defined and influenced by the BAV morphotype. METHODS: BAV valve morphology was defined according to number of raphes: type 0 (0 raphes), type 1 (1 raphe), or type 2 (2 raphes) and by the raphe location among the left (L), right (R) or non (N) coronary cusps...
February 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28185277/three-dimensional-parametric-modeling-of-bicuspid-aortopathy-and-comparison-with-computational-flow-predictions
#5
Salvatore Pasta, Giovanni Gentile, Giuseppe M Raffa, Francesco Scardulla, Diego Bellavia, Angelo Luca, Michele Pilato, Cesare Scardulla
Bicuspid aortic valve (BAV)-associated ascending aneurysmal aortopathy (namely "bicuspid aortopathy") is a heterogeneous disease making surgeon predictions particularly challenging. Computational flow analysis can be used to evaluate the BAV-related hemodynamic disturbances, which likely lead to aneurysm enlargement and progression. However, the anatomic reconstruction process is time consuming so that predicting hemodynamic and structural evolution by computational modeling is unfeasible in routine clinical practice...
February 10, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28182589/bicuspid-aortic-valve-aortopathy-mechanistic-and-clinical-insights-from-recent-studies
#6
David G Guzzardi, Subodh Verma, Paul W M Fedak
PURPOSE OF REVIEW: This focused review summarizes key insights from the past 12 months of basic science and clinical research on bicuspid aortic valve (BAV)-associated aortopathy. RECENT FINDINGS: Recent studies in BAV-associated aortopathy support a heterogeneous spectrum of disease with distinct phenotypes. Basic science studies provide further support for the concept of regional differences in the severity of aortopathy within the aorta of BAV patients. Clinical studies compared outcomes of BAV patients after isolated aortic valve replacement and showed that those with primarily valvular insufficiency as compared with stenosis may be at greater risk for important aortic events over time...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28129319/mini-bentall-an-interesting-approach-for-selected-patients
#7
Elisa Mikus, Antonio Micari, Simone Calvi, Maria Salomone, Marco Panzavolta, Marco Paris, Mauro Del Giglio
OBJECTIVE: Minimally invasive surgery through an upper hemisternotomy for aortic valve replacement has become the routine approach with excellent results. Actually, the same minimally invasive access is used for complex ascending aorta procedures only in few centers. We report our experience with minimally invasive approach for aortic valve and ascending aorta replacement using Bentall technique. METHODS: From January 2010 to November 2015, a total of 238 patients received ascending aorta and aortic valve replacement using Bentall De Bono procedure at our institution...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28102444/patients-with-bicuspid-and-tricuspid-aortic-valve-exhibit-distinct-regional-microrna-signatures-in-mildly-dilated-ascending-aorta
#8
Sebastian Albinsson, Alessandro Della Corte, Azra Alajbegovic, Katarzyna K Krawczyk, Ciro Bancone, Umberto Galderisi, Marilena Cipollaro, Marisa De Feo, Amalia Forte
MicroRNAs are able to modulate gene expression in a range of diseases. We focused on microRNAs as potential contributors to the pathogenesis of ascending aorta (AA) dilatation in patients with stenotic tricuspid (TAV) or bicuspid aortic valve (BAV). Aortic specimens were collected from the 'concavity' and the 'convexity' of mildly dilated AAs and of normal AAs from heart transplant donors. Aortic RNA was analyzed through PCR arrays, profiling the expression of 84 microRNAs involved in cardiovascular disease...
January 19, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28086801/two-dimensional-speckle-tracking-echocardiography-for-evaluation-of-dilative-ascending-aorta-biomechanics
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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