Bicuspid aortic stenosis natural history
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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 requiring operative correction in approximately 75% of cases.[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.
Complications
Bicuspid aortic valve has a varied clinical manifestation as listed below:
- Aortic stenosis in majority of patients.[2]
- Aortic insufficiency[4][5]
- Endocarditis[6]
- Aortic aneurysm[3]
- Aortic dissection[3]
- Sudden death can occur in children during and immediately after exertion especially among those with pressure gradient > 50 mmHg across the aortic valve.[7]
For complications of aortic stenosis, click here
References
- ↑ 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) - ↑ 2.0 2.1 2.2 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) - ↑ 3.0 3.1 3.2 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) - ↑ Keane MG, Wiegers SE, Plappert T, Pochettino A, Bavaria JE, Sutton MG (2000). "Bicuspid aortic valves are associated with aortic dilatation out of proportion to coexistent valvular lesions". Circulation. 102 (19 Suppl 3): III35–9. PMID 11082359. Retrieved 2012-04-10. Unknown parameter
|month=ignored (help) - ↑ Roberts WC, Morrow AG, McIntosh CL, Jones M, Epstein SE (1981). "Congenitally bicuspid aortic valve causing severe, pure aortic regurgitation without superimposed infective endocarditis. Analysis of 13 patients requiring aortic valve replacement". The American Journal of Cardiology. 47 (2): 206–9. PMID 7468467. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ Gersony WM, Hayes CJ, Driscoll DJ, Keane JF, Kidd L, O'Fallon WM, Pieroni DR, Wolfe RR, Weidman WH (1993). "Bacterial endocarditis in patients with aortic stenosis, pulmonary stenosis, or ventricular septal defect". Circulation. 87 (2 Suppl): I121–6. PMID 8425318. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ Keane JF, Driscoll DJ, Gersony WM, Hayes CJ, Kidd L, O'Fallon WM, Pieroni DR, Wolfe RR, Weidman WH (1993). "Second natural history study of congenital heart defects. Results of treatment of patients with aortic valvar stenosis". Circulation. 87 (2 Suppl): I16–27. PMID 8425319. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help)