Brief report
Aortic aneurysm in patients with functionally normal or minimally stenotic bicuspid aortic valve

https://doi.org/10.1016/0002-9149(91)90544-UGet rights and content

Abstract

Bicuspid aortic valve (BAV) is the most common form of congenital valvular disease, with a prevalence of approximately 1 to 2% in the general population.1 Aortic coarctation is often associated with BAV.1 A recent editorial by Lindsay2 has drawn attention once again to the concept that BAV and aortic coarctation may be manifestations of a single developmental anomaly—namely, aortic medial fragility. This idea was initially proposed by Abbot3 in 1928, revived by McKusick4 in 1972, and supported by circumstantial evidence referred to by Lindsay in his editorial. To prove that aortic medial fragility underlies BAV and aortic coarctation, one must demonstrate the presence of a pathologic or clinical correlate of aortic medial fragility in patients with the index conditions. The proposed pathologic correlate, cystic medial necrosis, is nonspecific. The clinical correlates of aortic medial fragility include aortic dilatation (aneurysm) or dissection. Although the data cited by Lindsay are suggestive of an increased prevalence of aortic dilatation/ dissection with BAV and coarctation, they could be expressions of the hemodynamic alterations accompanying the index conditions rather than manifestations of aortic medial fragility. To eliminate the confounding influence of hemodynamic disturbances, we studied the prevalence of aortic root dilatation (aneurysm) in patients with a functionally normal or minimally stenotic BAV. This study was to determine whether the aortic root at the sinus level is significantly dilated in patients with a functionally normal or minimally stenotic BAV, which we define as a resting mean aortic valve gradient <25 mm Hg, the absence of anything more than trivial aortic regurgitation and no coarctation as determined by Doppler echocardiography.

References (6)

There are more references available in the full text version of this article.

Cited by (153)

  • A Notch more: Molecular players in bicuspid aortic valve disease

    2019, Journal of Molecular and Cellular Cardiology
View all citing articles on Scopus
View full text