Bicuspid aortic stenosis natural history: Difference between revisions

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==Natural History==
==Natural History==
Bicuspid aortic valve have two distinct anatomical configurations:
#Antero-posterior orientation of the commissures resulting in right and left cusps. This occurs in approximately 53 percent of cases.<ref name="pmid5427836">{{cite journal |author=Roberts WC |title=The congenitally bicuspid aortic valve. A study of 85 autopsy cases |journal=[[The American Journal of Cardiology]] |volume=26 |issue=1 |pages=72–83 |year=1970 |month=July |pmid=5427836 |doi= |url= |accessdate=2012-04-09}}</ref>
#47 percent of patients have commissures on right and left sides of annulus resulting in anterior and posterior cusps.<ref name="pmid5427836">{{cite journal |author=Roberts WC |title=The congenitally bicuspid aortic valve. A study of 85 autopsy cases |journal=[[The American Journal of Cardiology]] |volume=26 |issue=1 |pages=72–83 |year=1970 |month=July |pmid=5427836 |doi= |url= |accessdate=2012-04-09}}</ref>


Bicuspid aortic valve, during childhood functions without any significant pressure gradient. However, the thickening and calcification of the valves may be detectable pathologically and on echocardiography by second decade<ref name="pmid8427176">{{cite journal |author=Beppu S, Suzuki S, Matsuda H, Ohmori F, Nagata S, Miyatake K |title=Rapidity of progression of aortic stenosis in patients with congenital bicuspid aortic valves |journal=[[The American Journal of Cardiology]] |volume=71 |issue=4 |pages=322–7 |year=1993 |month=February |pmid=8427176 |doi= |url= |accessdate=2012-04-09}}</ref>. This progresses to aortic stenosis in approximately 75% of cases requiring surgery.<ref name="pmid835475">{{cite journal |author=Fenoglio JJ, McAllister HA, DeCastro CM, Davia JE, Cheitlin MD |title=Congenital bicuspid aortic valve after age 20 |journal=[[The American Journal of Cardiology]] |volume=39 |issue=2 |pages=164–9 |year=1977 |month=February |pmid=835475 |doi= |url= |accessdate=2012-04-10}}</ref><ref name="pmid15723989">{{cite journal |author=Lewin MB, Otto CM |title=The bicuspid aortic valve: adverse outcomes from infancy to old age |journal=[[Circulation]] |volume=111 |issue=7 |pages=832–4 |year=2005 |month=February |pmid=15723989 |doi=10.1161/01.CIR.0000157137.59691.0B |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15723989 |accessdate=2012-04-10}}</ref>
Bicuspid aortic valve, during childhood functions without any significant pressure gradient. However, the thickening and calcification of the valves may be detectable pathologically and on echocardiography by second decade<ref name="pmid8427176">{{cite journal |author=Beppu S, Suzuki S, Matsuda H, Ohmori F, Nagata S, Miyatake K |title=Rapidity of progression of aortic stenosis in patients with congenital bicuspid aortic valves |journal=[[The American Journal of Cardiology]] |volume=71 |issue=4 |pages=322–7 |year=1993 |month=February |pmid=8427176 |doi= |url= |accessdate=2012-04-09}}</ref>. This progresses to aortic stenosis in approximately 75% of cases requiring surgery.<ref name="pmid835475">{{cite journal |author=Fenoglio JJ, McAllister HA, DeCastro CM, Davia JE, Cheitlin MD |title=Congenital bicuspid aortic valve after age 20 |journal=[[The American Journal of Cardiology]] |volume=39 |issue=2 |pages=164–9 |year=1977 |month=February |pmid=835475 |doi= |url= |accessdate=2012-04-10}}</ref><ref name="pmid15723989">{{cite journal |author=Lewin MB, Otto CM |title=The bicuspid aortic valve: adverse outcomes from infancy to old age |journal=[[Circulation]] |volume=111 |issue=7 |pages=832–4 |year=2005 |month=February |pmid=15723989 |doi=10.1161/01.CIR.0000157137.59691.0B |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15723989 |accessdate=2012-04-10}}</ref>

Revision as of 02:14, 11 April 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

Natural History

Bicuspid aortic valve, during childhood functions without any significant pressure gradient. However, the thickening and calcification of the valves may be detectable pathologically and on echocardiography by second decade[1]. This progresses to aortic stenosis in approximately 75% of cases requiring surgery.[2][3]

Bicuspid aortic stenosis progressively leads to heart failure, arrythmias, angina and other symptoms which generally manifests between 40 to 60 years of age which is relatively younger to manifestation of aortic stenosis otherwise.[2] However, children who develop early pathologic changes in bicuspid aortic valve are more likely to develop aortic insufficiency than stenosis.

References

  1. ↑ Beppu S, Suzuki S, Matsuda H, Ohmori F, Nagata S, Miyatake K (1993). "Rapidity of progression of aortic stenosis in patients with congenital bicuspid aortic valves". The American Journal of Cardiology. 71 (4): 322–7. PMID 8427176. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  2. ↑ 2.0 2.1 Fenoglio JJ, McAllister HA, DeCastro CM, Davia JE, Cheitlin MD (1977). "Congenital bicuspid aortic valve after age 20". The American Journal of Cardiology. 39 (2): 164–9. PMID 835475. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  3. ↑ Lewin MB, Otto CM (2005). "The bicuspid aortic valve: adverse outcomes from infancy to old age". Circulation. 111 (7): 832–4. doi:10.1161/01.CIR.0000157137.59691.0B. PMID 15723989. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)

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