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Aorta bicuspide

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https://www.readbyqxmd.com/read/29149323/should-the-dilated-ascending-aorta-be-repaired-at-the-time-of-bicuspid-aortic-valve-replacement
#1
Tsuyoshi Kaneko, Prem Shekar, Vladimir Ivkovic, Nicholas T Longford, Chuan-Chin Huang, Martin I Sigurdsson, Robert C Neely, Maroun Yammine, Julius I Ejilofor, Vanessa Montiero Vieira, Jasmine T Shahram, Karam M Habchi, Gregory W Malzberg, Peter S Martin, Jordan Bloom, Eric M Isselbacher, J Daniel Muehlschlegel, Thoralf M Sundt, Simon C Body
OBJECTIVES: Bicuspid aortic valve (BAV) is the most common congenital valvular abnormality and frequently presents with accelerated calcific aortic valve disease, requiring aortic valve replacement (AVR) and thoracic aortic aneurysm and dissection. Supporting evidence for Association Guidelines of aortic dimensions for aortic resection is sparse. We sought to determine whether concurrent repair of dilated or aneurysmal aortic disease during AVR in patients with BAV substantially improves morbidity and mortality outcomes...
November 14, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29147966/polyamine-concentration-is-increased-in-thoracic-ascending-aorta-of-patients-with-bicuspid-aortic-valve
#2
Amalia Forte, Mario Grossi, Ciro Bancone, Marilena Cipollaro, Marisa De Feo, Per Hellstrand, Lo Persson, Bengt-Olof Nilsson, Alessandro Della Corte
Polyamines are cationic molecules synthesized via a highly regulated pathway, obtained from the diet or produced by the gut microbiota. They are involved in general molecular and cellular phenomena that play a role also in vascular disease. Bicuspid aortic valve (BAV) is a congenital malformation associated to a greater risk of thoracic ascending aorta (TAA) aneurysm, whose pathogenesis is not yet well understood. We focused on differential analysis of key members of polyamine pathway and on polyamine concentration in non-dilated TAA samples from patients with either stenotic tricuspid aortic valve (TAV) or BAV (diameter ≤ 45 mm), vs...
November 17, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29108714/not-z-end-of-the-story-do-z-scores-help-to-guide-surgical-decisions-about-the-ascending-aorta-in-patients-with-bicuspid-aortic-valve
#3
EDITORIAL
Siddharth K Prakash, Anthony L Estrera
No abstract text is available yet for this article.
October 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29095713/bicuspid-aortic-valve-associated-aortopathy-update-on-biomarkers
#4
Ashna K Maredia, Steven C Greenway, Subodh Verma, Paul W M Fedak
PURPOSE OF REVIEW: Bicuspid aortic valve (BAV)-associated aortopathy is common and its progression for individual patients is difficult to predict. The present review aims to identify recent developments using biomarkers for the determination of risk and progression of disease in patients with BAV aortopathy. RECENT FINDINGS: Novel rare genetic variants and epigenetic methylation signatures affecting non-cytosine phosphate guanine (non-CpG) and CpG sites, nicotinamide phosphoribosyltransferase and Sod expression may lead to improved prediction of the aortopathy phenotype...
October 31, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29042101/machine-learning-phenotypic-classification-of-bicuspid-aortopathy
#5
Charles M Wojnarski, Eric E Roselli, Jay J Idrees, Yuanjia Zhu, Theresa A Carnes, Ashley M Lowry, Patrick H Collier, Brian Griffin, John Ehrlinger, Eugene H Blackstone, Lars G Svensson, Bruce W Lytle
BACKGROUND: Bicuspid aortic valves (BAV) are associated with incompletely characterized aortopathy. Our objectives were to identify distinct patterns of aortopathy using machine-learning methods and characterize their association with valve morphology and patient characteristics. METHODS: We analyzed preoperative 3-dimensional computed tomography reconstructions for 656 patients with BAV undergoing ascending aorta surgery between January 2002 and January 2014. Unsupervised partitioning around medoids was used to cluster aortic dimensions...
September 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29029085/impairment-of-elastic-properties-of-the-aorta-in-bicuspid-aortic-valve-relationship-between-biomolecular-and-aortic-strain-patterns
#6
Luca Longobardo, Maria Ludovica Carerj, Gabriele Pizzino, Alessandra Bitto, Maurizio Cusma Piccione, Marta Zucco, Lilia Oreto, Maria Chiara Todaro, Maria Pia Calabrò, Francesco Squadrito, Gianluca Di Bella, Giuseppe Oreto, Bijoy K Khandheria, Scipione Carerj, Concetta Zito
Aims: Bicuspid aortic valve (BAV) is associated with aortic wall alterations. We aimed to detect any correlation between aortic elasticity and genetic and biomolecular patterns of elastin. Methods and results: Forty-nine BAV patients (mean age: 38 ± 17.05) were prospectively enrolled. A blood sample was drawn for analysis of a single nucleotide polymorphism of elastin gene (ELN rs2071307) responsible for misfolding of elastin, and for the amount of elastin soluble fragments (ESF) in the plasma...
September 23, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29029058/inter-ethnic-differences-in-valve-morphology-valvular-dysfunction-and-aortopathy-between-asian-and-european-patients-with-bicuspid-aortic-valve
#7
William K F Kong, Madelien V Regeer, Kian K Poh, James W Yip, Philippe J van Rosendael, Tiong C Yeo, Edgar Tay, Vasileios Kamperidis, Enno T van der Velde, Bart Mertens, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
Background: Transcatheter aortic valve replacement (TAVR) has been shown safe and feasible in patients with bicuspid aortic valve (BAV) morphology. Evaluation of inter-ethnic differences in valve morphology and function and aortic root dimensions in patients with BAV is important for the worldwide spread of this therapy in this subgroup of patients. Comparisons between large European and Asian cohorts of patients with BAV have not been performed, and potential differences between populations may have important implications for TAVR...
October 6, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28987740/longer-term-results-z-scores-and-decision-nomograms-for-treatment-of-the-ascending-aorta-in-1693-bicuspid-aortic-valve-operations
#8
Hans-Hinrich Sievers, Sina Stock, Ulrich Stierle, Stefan Klotz, Efstratios I Charitos, Michael Diwoky, Doreen Richardt
OBJECTIVE: This study aims to fine-tune the decision making for ascending aorta treatment in bicuspid aortic valve surgery. METHODS: A total of 1693 patients with a primary indication for aortic valve surgery were investigated retrospectively with respect to a multifactorial decision-making policy including the z score and the clinical outcome in relation to different techniques for ascending aorta treatment (no intervention n = 1116; intervention n = 577 either by ascending aorta replacement n = 404 or aortoplasty n = 173)...
September 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28983176/bentall-operation-in-a-patient-with-an-anomalous-left-circumflex-artery-case-report-and-review
#9
Ivo Gasparovic, Panagiotis Artemiou, Mikulas Kiss, Michal Hulman
Anomalous origin of a left circumflex artery from the right coronary sinus represents a technical challenge in patients who require aortic valve/root procedures. This case report describes a patient who presented with bicuspid aortic valve, anomalous origin of the circumflex artery, severe aortic regurgitation, and aneurysm of the ascending aorta as well as aortic root that was safely managed following the Bentall procedure with the combined button technique.
October 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28982503/clinical-outcomes-following-the-ross%C3%A2-procedure-in-adults-a-25-year-longitudinal-study
#10
Elisabeth Martin, Siamak Mohammadi, Frederic Jacques, Dimitri Kalavrouziotis, Pierre Voisine, Daniel Doyle, Jean Perron
BACKGROUND: Very few reports of long-term outcomes of patients who underwent the Ross procedure have been published. OBJECTIVES: The authors reviewed their 25-year experience with the Ross procedure with the aim of defining very-long-term survival and factors associated with Ross-related failure. METHODS: Between January 1990 and December 2014, the Ross procedure was performed in 310 adults (mean age 40.8 years) at a single institution. All patients were prospectively added to a dedicated cardiac surgery registry...
October 10, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28980342/3d-axial-and-circumferential-wall-shear-stress-from-4d-flow-mri-data-using-a-finite-element-method-and-a-laplacian-approach
#11
Julio Sotelo, Lydia Dux-Santoy, Andrea Guala, José Rodríguez-Palomares, Arturo Evangelista, Carlos Sing-Long, Jesús Urbina, Joaquín Mura, Daniel E Hurtado, Sergio Uribe
PURPOSE: To decompose the 3D wall shear stress (WSS) vector field into its axial (WSSA ) and circumferential (WSSC ) components using a Laplacian finite element approach. METHODS: We validated our method with in silico experiments involving different geometries and a modified Poiseuille flow. We computed 3D maps of the WSS, WSSA , and WSSC using 4D flow MRI data obtained from 10 volunteers and 10 patients with bicuspid aortic valve (BAV). We compared our method with the centerline method...
October 4, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28970802/characteristics-of-carotid-artery-structure-and-mechanical-function-and-their-relationships-with-aortopathy-in-patients-with-bicuspid-aortic-valves
#12
Mihyun Kim, Chi Young Shim, Seong-Chan You, In-Jeong Cho, Geu-Ru Hong, Jong-Won Ha, Namsik Chung
Patients with a bicuspid aortic valve (BAV) often have proximal aortic dilatation and systemic vascular dysfunction. We hypothesized that BAV patients would have different carotid artery structural and functional characteristics compared to tricuspid aortic valve (TAV) patients. In 28 patients with surgically confirmed BAV and 27 patients with TAV, intima media thickness (IMT), number of plaques, fractional area change (FAC), global circumferential strain (GCS), and standard deviation of CS (SD-CS) in both common carotid arteries were assessed using duplex ultrasound and velocity vector imaging (VVI)...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28950334/ascending-aorta-dilatation-rates-in-patients-with-tricuspid-and-bicuspid-aortic-stenosis-the-cofrasa-generac-study
#13
Caroline Kerneis, Nicoletta Pasi, Dimitri Arangalage, Virginia Nguyen, Tiffany Mathieu, Constance Verdonk, Isabelle Codogno, Phalla Ou, Xavier Duval, Sarah Tubiana, Claire Cimadevilla, Alec Vahanian, And David Messika-Zeitoun
Background: Ascending aorta (AA) dilatation is common in aortic valve stenosis (AS) but data regarding AA progression, its determinants and impact of valve anatomy [bicuspid (BAV), or tricuspid (TAV)] are scarce. Methods and Results: Asymptomatic AS patients enrolled in a prospective cohort (COFRASA/GENERAC) with at least 2 years of follow-up were considered in the present analysis. A transthoracic echocardiography (TTE) and a computed tomography (CT) scan were performed at inclusion and yearly thereafter...
July 25, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28948327/abnormal-longitudinal-growth-of-the-aorta-in-children-with-familial-bicuspid-aortic-valve
#14
Holly Nadorlik, Jessica L Bowman, Sara Fitzgerald-Butt, May Ling Mah, Kim L McBride, John P Kovalchin, Vidu Garg
Bicuspid aortic valve (BAV) is the most common type of congenital heart defect (CHD) and is associated with clinically significant cardiovascular complications including valve calcification and ascending aortopathy (AscAo), predominantly occurring in adulthood. While a limited number of genetic etiologies for BAV have been defined, family members of affected individuals display BAV along with other left-sided CHD. This has led to guidelines from the American Heart Association and American College of Cardiology that recommend echocardiographic screening of first-degree relatives of affected adults...
September 25, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28906534/management-of-a-complicated-redo-giant-dissecting-aortic-aneurysm
#15
Ibrahim Kara, Alper Erkin, MHalil Ibrahim Erkengel, Kiyasettin Asil
Giant aortic aneurysm is defined as an aneurysm of the aorta of greater than 10 cm in diameter. This rare condition is associated with a high risk of morbidity and mortality and it may lead to fatal complications such as rupture and/or dissection if not managed with proper surgical planning and expertise. Other than atherosclerosis, the main causes of giant ascending aortic aneurysms include Marfan and Ehlers-Danhlos syndromes. Herein we report on a young male patient who had had an aortic valve replacement five years earlier due to a bicuspid aortic valve leading to aortic failure, accompanied by aortic coarctation...
July 23, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28903936/aortic-valve-stenosis-alters-expression-of-regional-aortic-wall-shear-stress-new-insights-from-a-4-dimensional-flow-magnetic-resonance-imaging-study-of-571-subjects
#16
Pim van Ooij, Michael Markl, Jeremy D Collins, James C Carr, Cynthia Rigsby, Robert O Bonow, S Chris Malaisrie, Patrick M McCarthy, Paul W M Fedak, Alex J Barker
BACKGROUND: Wall shear stress (WSS) is a stimulus for vessel wall remodeling. Differences in ascending aorta (AAo) hemodynamics have been reported between bicuspid aortic valve (BAV) and tricuspid aortic valve patients with aortic dilatation, but the confounding impact of aortic valve stenosis (AS) is unknown. METHODS AND RESULTS: Five hundred seventy-one subjects underwent 4-dimensional flow magnetic resonance imaging in the thoracic aorta (210 right-left BAV cusp fusions, 60 right-noncoronary BAV cusp fusions, 245 tricuspid aortic valve patients with aortic dilatation, and 56 healthy controls)...
September 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28890987/impact-of-patient-specific-inflow-velocity-profile-on-hemodynamics-of-the-thoracic-aorta
#17
Pouya Youssefi, Alberto Gomez, Christopher Arthurs, Rajan Sharma, Marjan Jahangiri, C Alberto Figueroa
Computational fluid dynamics (CFD) provides a noninvasive method to functionally assess aortic hemodynamics. The thoracic aorta has an anatomically complex inlet comprising of the aortic valve and root, which is highly prone to different morphologies and pathologies. We investigated the effect of using patient-specific (PS) inflow velocity profiles compared to idealized profiles based on the patient's flow waveform. A healthy 31 yo with a normally functioning tricuspid aortic valve (subject A), and a 52 yo with a bicuspid aortic valve (BAV), aortic valvular stenosis, and dilated ascending aorta (subject B) were studied...
January 1, 2018: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28886508/effects-of-clinico-pathological-risk-factors-on-in-vitro-mechanical-properties-of-human-dilated-ascending-aorta
#18
Anna Ferrara, Pasquale Totaro, Simone Morganti, Ferdinando Auricchio
Ascending aorta aneurysms (AsAA) are associated with a degeneration of the aortic wall tissue, which leads to changes in tissue mechanical properties. Risk factors for the development of the AsAA disease are recognized in patient age and gender, valve type, hypertension, diabetes mellitus, smoking history, and a prior diagnosis of Marfan syndrome. The present study aims to assess how such clinico-pathological factors can affect the mechanical properties of human dilated ascending aorta. Specimens of AsAA are excised from 68 patients who underwent elective AsAA surgical repair and stretched until rupture during the execution of uniaxial tensile tests...
August 31, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28884233/in-vivo-strain-analysis-of-dilated-ascending-thoracic-aorta-by-ecg-gated-ct-angiographic-imaging
#19
Salvatore Pasta, Valentina Agnese, Marzio Di Giuseppe, Giovanni Gentile, Giuseppe M Raffa, Diego Bellavia, Michele Pilato
Accurate assessment of aortic extensibility is a requisite first step for elucidating the pathophysiology of an ascending thoracic aortic aneurysm (ATAA). This study aimed to develop a framework for the in vivo evaluation of the full-field distribution of the aortic wall strain by imaging analysis of electrocardiographic- (ECG) gated thoracic data of 34 patients with ATAA. Seven healthy controls (i.e., non-aneurysmal aorta) from patients who underwent ECG-gated CT angiography for coronary artery diseases were included for comparison...
September 7, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28871348/characterization-of-complex-flow-patterns-in-the-ascending-aorta-in-patients-with-aortic-regurgitation-using-conventional-phase-contrast-velocity-mri
#20
Odd Bech-Hanssen, Frida Svensson, Christian L Polte, Åse A Johnsson, Sinsia A Gao, Kerstin M Lagerstrand
Ascending aorta (AA) flow displacement (FD) is a surrogate for increased wall shear stress. We prospectively studied the flow profile in the AA in patients with aortic regurgitation (AR), to identify predictors of FD and investigate whether magnetic resonance imaging (MRI) phase-contrast flow rate curves (PC-FRC) contain quantitative information related to FD. Forty patients with chronic moderate (n = 14) or severe (n = 26) AR (21 (53%) with bicuspid aortic valve) and 22 controls were investigated. FD was determined from phase-contrast velocity profiles and defined as the distance between the center of the lumen and the "center of velocity" of the peak systolic forward flow or the peak diastolic negative flow, normalized to the lumen radius...
September 4, 2017: International Journal of Cardiovascular Imaging
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