Background: To study the following characteristics of bicuspid aortic valves (BAVs): 1) the recurrence rate in our population, 2) patterns of hereditary transmission in different BAV morphologies and 3) the aortic dimensions of BAVs in first-degree relatives (FDRs).
Methods: A cross-sectional, prospective study of 100 consecutive families of BAV patients attending a university hospital. The following aortic valve morphologies were analysed and categorised: fusion of the right and left coronary cusps (BAV type A), right and noncoronary cusps (type B) and of the left and noncoronary cusps (type C).
Results: There were 553 subjects studied, 100 cases with a BAV (46.8±15 years, 66% male, type 67% A, 32% B and 1% C; 42% with aortic dilatation), 348 FDRs (44.8% male), and 105 healthy control subjects (50% male). We detected 16 BAVs among 348 FDRs. The recurrence rates were 15% for families, 4.6% for FDRs, 7.05% in men and 2.60% in women. The morphologic concordance in family members was 68.8%. The aortic dimensions in 270 adult FDRs with a tricuspid aortic valve were significantly smaller compared with BAV patients (sinus index diameter 1.60±0.19 cm/m(2) vs. 1.82±0.29 cm/m(2), p<0.001; tubular index diameter 1.51±0.23 cm/m(2) vs. 2.00±0.45 cm/m(2), p<0.001) and similar to 103 control subjects(sinus index diameter 1.60±0.19 cm/m(2) vs. 1.59±0.17 cm/m(2), p=0.600 and tubular index diameter 1.51±0.23 cm/m(2) vs. 1.53±0.18 cm/m(2), p=0.519).
Conclusions: In our population, the BAV recurrence rate in FDRs was low (4.6%). The hereditary transmission of morphologic BAV types seems by chance, and the aortic dimensions in tricuspid FDRs are normal.
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http://dx.doi.org/10.1016/j.ijcard.2013.04.180 | DOI Listing |
JACC Case Rep
January 2025
Te Whatu Ora (Health New Zealand), Waikato Hospital, Hamilton, New Zealand.
A 77-year-old man with a history of a Bentall procedure presented with acute decompensated heart failure. Investigations revealed severe bioprosthetic aortic valve regurgitation and a large pseudoaneurysm eroding the sternum. We describe the multimodal imaging and heart team planning to stent the pseudoaneurysm with an endograft followed by transcatheter valve-in-valve implantation.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Heart, Vascular, and Thoracic Institute, Cleveland Clinic London, London, United Kingdom.
We describe the case of a 52-year-old man with radiation-induced severe mixed aortic and mitral valve disease, thickening of the aortomitral continuity, mitral annular calcification, and porcelain aorta with limited transcatheter treatment options. By replacing the aorta during circulatory arrest, we demonstrate that it is possible to clamp the ascending aorta to facilitate prosthetic aortic and mitral valve replacement.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy.
Echocardiography is a well-established tool for evaluating bioprosthetic valve performance after transcatheter aortic valve replacement. The presence of higher-than-expected echocardiographic gradients is not an uncommon finding and can be related to different clinical settings. This case series proposes a practical and multiparametric approach to interpreting high residual gradients after transcatheter aortic valve replacement.
View Article and Find Full Text PDFJACC Adv
February 2025
Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
Background: Degenerative severe aortic stenosis (AS) is treated by valve replacement to improve outcome. Despite diagnostic advancements, many AS patients are still diagnosed late with advanced heart failure.
Objectives: The aim of the study was to assess multiorgan dysfunction in severe AS using blood biomarkers and their association with quantitative fluid levels and clinical outcomes after transcatheter aortic valve implantation (TAVI).
JACC Adv
February 2025
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Background: Clonal hematopoiesis of indeterminate potential (CHIP) has been linked to intensified systemic inflammation and represents a novel risk factor for atherosclerotic cardiovascular diseases, including aortic stenosis (AS).
Objectives: This study aimed to assess the clinical impact of CHIP in a cohort of severe AS patients undergoing transcatheter aortic valve implantation (TAVI).
Methods: We enrolled 110 severe AS patients in this retrospective study.
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