Cargando…
Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy
Bicuspid aortic valve (BAV) is a common congenital cardiac malformation affecting 1–2% of people. BAV results from fusion of two adjacent aortic valve cusps, and is associated with dilatation of the aorta, known as bicuspid valve associated aortopathy. Bicuspid valve aortopathy is progressive and as...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502281/ https://www.ncbi.nlm.nih.gov/pubmed/28740468 http://dx.doi.org/10.3389/fphys.2017.00475 |
_version_ | 1783248924639756288 |
---|---|
author | Fatehi Hassanabad, Ali Barker, Alex J. Guzzardi, David Markl, Michael Malaisrie, Chris McCarthy, Patrick M. Fedak, Paul W. M. |
author_facet | Fatehi Hassanabad, Ali Barker, Alex J. Guzzardi, David Markl, Michael Malaisrie, Chris McCarthy, Patrick M. Fedak, Paul W. M. |
author_sort | Fatehi Hassanabad, Ali |
collection | PubMed |
description | Bicuspid aortic valve (BAV) is a common congenital cardiac malformation affecting 1–2% of people. BAV results from fusion of two adjacent aortic valve cusps, and is associated with dilatation of the aorta, known as bicuspid valve associated aortopathy. Bicuspid valve aortopathy is progressive and associated with catastrophic clinical events, such as aortic dissection and rupture. Therefore, frequent monitoring and early intervention with prophylactic surgical resection of the proximal aorta is often recommended. However, the specific pattern of aortopathy is highly variable among patients, with different segments of the ascending aorta being affected. Individual patient risks are sometimes difficult to predict. Resection strategies are informed by current surgical guidelines which are primarily based on aortic size and growth criteria. These criteria may not optimally reflect the risk of important aortic events. To address these issues in the care of patients with bicuspid valve aortopathy, our translational research group has focused on validating use of novel imaging techniques to establish non-invasive hemodynamic biomarkers for risk-stratifying BAV patients. In this article, we review recent efforts, successes, and ongoing challenges in the development of more precise and individualized surgical approaches for patients with bicuspid aortic valves and associated aortic disease. |
format | Online Article Text |
id | pubmed-5502281 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-55022812017-07-24 Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy Fatehi Hassanabad, Ali Barker, Alex J. Guzzardi, David Markl, Michael Malaisrie, Chris McCarthy, Patrick M. Fedak, Paul W. M. Front Physiol Physiology Bicuspid aortic valve (BAV) is a common congenital cardiac malformation affecting 1–2% of people. BAV results from fusion of two adjacent aortic valve cusps, and is associated with dilatation of the aorta, known as bicuspid valve associated aortopathy. Bicuspid valve aortopathy is progressive and associated with catastrophic clinical events, such as aortic dissection and rupture. Therefore, frequent monitoring and early intervention with prophylactic surgical resection of the proximal aorta is often recommended. However, the specific pattern of aortopathy is highly variable among patients, with different segments of the ascending aorta being affected. Individual patient risks are sometimes difficult to predict. Resection strategies are informed by current surgical guidelines which are primarily based on aortic size and growth criteria. These criteria may not optimally reflect the risk of important aortic events. To address these issues in the care of patients with bicuspid valve aortopathy, our translational research group has focused on validating use of novel imaging techniques to establish non-invasive hemodynamic biomarkers for risk-stratifying BAV patients. In this article, we review recent efforts, successes, and ongoing challenges in the development of more precise and individualized surgical approaches for patients with bicuspid aortic valves and associated aortic disease. Frontiers Media S.A. 2017-07-10 /pmc/articles/PMC5502281/ /pubmed/28740468 http://dx.doi.org/10.3389/fphys.2017.00475 Text en Copyright © 2017 Fatehi Hassanabad, Barker, Guzzardi, Markl, Malaisrie, McCarthy and Fedak. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Physiology Fatehi Hassanabad, Ali Barker, Alex J. Guzzardi, David Markl, Michael Malaisrie, Chris McCarthy, Patrick M. Fedak, Paul W. M. Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy |
title | Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy |
title_full | Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy |
title_fullStr | Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy |
title_full_unstemmed | Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy |
title_short | Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy |
title_sort | evolution of precision medicine and surgical strategies for bicuspid aortic valve-associated aortopathy |
topic | Physiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502281/ https://www.ncbi.nlm.nih.gov/pubmed/28740468 http://dx.doi.org/10.3389/fphys.2017.00475 |
work_keys_str_mv | AT fatehihassanabadali evolutionofprecisionmedicineandsurgicalstrategiesforbicuspidaorticvalveassociatedaortopathy AT barkeralexj evolutionofprecisionmedicineandsurgicalstrategiesforbicuspidaorticvalveassociatedaortopathy AT guzzardidavid evolutionofprecisionmedicineandsurgicalstrategiesforbicuspidaorticvalveassociatedaortopathy AT marklmichael evolutionofprecisionmedicineandsurgicalstrategiesforbicuspidaorticvalveassociatedaortopathy AT malaisriechris evolutionofprecisionmedicineandsurgicalstrategiesforbicuspidaorticvalveassociatedaortopathy AT mccarthypatrickm evolutionofprecisionmedicineandsurgicalstrategiesforbicuspidaorticvalveassociatedaortopathy AT fedakpaulwm evolutionofprecisionmedicineandsurgicalstrategiesforbicuspidaorticvalveassociatedaortopathy |