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Aortic dilatation in patients with bicuspid aortic valve

Cecconi, Moreno; Nistri, Stefano; Quarti, Andrea; Manfrin, Marcello; Colonna, Pier Luigi; Molini, Epifanio; Perna, Gian Piero

Journal of Cardiovascular Medicine: January 2006 - Volume 7 - Issue 1 - p 11–20
doi: 10.2459/01.JCM.0000199777.85343.ec
Current perspectives
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The association of a bicuspid aortic valve (BAV) with abnormalities of the proximal thoracic aorta, including dilatation, aneurysm and dissection, has been previously described, leading to the hypothesis of a common underlying developmental defect involving the aortic valve and the aortic wall. Consequently, any patient with BAV should receive a careful assessment not only of the valve function, but also of the aortic root and the ascending aorta. Dilatation of the proximal thoracic aorta is a common finding in patients with BAV and is believed to be related to aortic rupture and dissection. Because progressive dilatation can occur, careful long-term surveillance of the aortic dimensions is required. Prophylactic surgical repair of the dilated aorta should be recommended more aggressively for patients with BAV than for those with a tricuspid aortic valve. However, the optimal timing of aortic surgery in BAV patients remains uncertain because of the limited data available on the natural history of asymptomatic aortic dilatation.

aPresidio Monospecialistico di Alta Specializzazione ‘G.M. Lancisi’, Ospedali Riuniti Umberto I – G.M. Lancisi – G. Salesi, Ancona

bServizio di Cardiologia, CMSR-Veneto Medica, Altavilla Vicentina, Italy

Received 18 February, 2005

Revised 16 May, 2005

Accepted 18 May, 2005

Correspondence and requests for reprints to Dr Moreno Cecconi, Via Guazzatore 66, 60027 Osimo (AN), Italy. Tel: +39 (0)71 596 5030; fax: +39 (0)71 723 2165; e-mail: morcecconi@tiscalinet.it

© 2006 Italian Federation of Cardiology. All rights reserved.