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Bicuspid aortic valve aortopathy: mechanistic and clinical insights from recent studies

Guzzardi, David G.; Verma, Subodh; Fedak, Paul W.M.

Current Opinion in Cardiology: March 2017 - Volume 32 - Issue 2 - p 111–116
doi: 10.1097/HCO.0000000000000359
VALVULAR HEART DISEASE: Edited by Subodh Verma

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. These novel insights will be important to optimize future aortic resection strategies and clinical practice guidelines.

Summary As the most common congenital heart defect, BAV disease is a considerable health burden. Recent studies show differences in the clinical manifestation of disease patterns that may have important implications for future research and the evolution toward more patient-specific surgical practice guidelines.

aSection of Cardiac Surgery, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta

bDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada

cMartha and Richard Melman Family Bicuspid Aortic Valve Program, Bluhm Cardiovascular Institute, Northwestern University, Chicago, Illinois, USA

Correspondence to Dr Paul W.M. Fedak, MD, PhD, C880, 1403 – 29th Street NW, Calgary, AB T2N 2T9, Canada. Tel: +1 403 944 5931; fax: +1 403 270 3715; e-mail:

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