Materiały źródłowe

• #1 Bicuspid Aortic Valve

  https://my.clevelandclinic.org/health/diseases/16780-bicuspid-aortic-valve-disease

  A bicuspid aortic valve can cause serious complications like heart failure. But with treatment, it wont affect your life expectancy and you can lead a healthy life. […] Bicuspid aortic valve disease treatment involves surgery for about 4 out of 5 people with this problem. Your surgeon will either repair or replace your aortic valve. […] Its important to have surgery early enough to prevent permanent damage to your heart. Even if you dont have symptoms, your provider may want to fix the problem now to avoid complications down the road. […] New technology continues to improve outcomes and reduce complications. Many people can have minimally invasive techniques instead of traditional open-heart surgery. […] Aortic valve repair fixes your valve without replacing it. It can be a good option for aortic regurgitation (leaky valve).

• #2 Mayo Clinic Q and A: Treatment and management of bicuspid aortic valve – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-treatment-and-management-of-bicuspid-aortic-valve/

  A new diagnosis of a bicuspid aortic valve usually does not require immediate intervention or have significant health effects in the short- or mid-term. It does require lifelong surveillance because it may cause heart problems in the long term. Over half of patients will need aortic valve repair or replacement within 25 years after bicuspid aortic valve diagnosis. […] Treatment of the bicuspid aortic valve depends on the extent of the valve’s disease, the patient’s symptoms and the size of the aorta. Open-heart surgery may be needed if the narrowing or leakiness is severe or the patient is experiencing symptoms. […] The most commonly performed procedure is aortic valve replacement, with either an artificial mechanical valve or a biological tissue valve. In certain cases of a leaky valve, repair of the aortic valve may be more feasible than replacement, which is more advantageous, especially in younger patients.

• #3 A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10531880/

  The management of BAV presents a complex and critical challenge in cardiovascular medicine. […] Medical treatment options for BAV patients are limited, with more than half requiring AVR during their lifetime, and 25% undergoing aortic replacement surgery. […] For patients diagnosed with bicuspid aortic valve disease and an indication for AVR, current guidelines recommend surgical AVR (SAVR) with a class I recommendation, provided the patient is suitable for the procedure. […] However, ongoing research is shedding light on whether this surgical intervention will involve repair or replacement in cases of aortic regurgitation. […] A meta-analysis published in 2019, comparing replacement and repair in aortic regurgitation, revealed that the perioperative outcomes of repair were comparable to those of replacement.

• #4 Bicuspid aortic valve – Overview – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bicuspid-aortic-valve/cdc-20385577

  If you have a bicuspid aortic valve, you are usually sent to a doctor trained in congenital heart disease. This type of doctor is called a congenital cardiologist. […] Treatment for a bicuspid aortic valve depends on how severe the heart valve disease is. It may include medicines or a procedure or surgery to fix or replace the valve. […] There are no medicines to repair a bicuspid aortic valve. But medicines may be used to treat symptoms caused by heart valve disease. For example, your healthcare professional may recommend blood pressure medicine. […] Surgery may be needed if a bicuspid aortic valve is causing: Aortic valve stenosis. Aortic valve regurgitation. An enlarged aorta. […] Surgery is done to repair or replace the aortic valve. The type of surgery done depends on the specific heart valve condition and your symptoms.

• #5 Mayo Clinic Q and A: Treatment and management of bicuspid aortic valve – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-treatment-and-management-of-bicuspid-aortic-valve/

  A new diagnosis of a bicuspid aortic valve usually does not require immediate intervention or have significant health effects in the short- or mid-term. It does require lifelong surveillance because it may cause heart problems in the long term. Over half of patients will need aortic valve repair or replacement within 25 years after bicuspid aortic valve diagnosis. […] Treatment of the bicuspid aortic valve depends on the extent of the valve’s disease, the patient’s symptoms and the size of the aorta. Open-heart surgery may be needed if the narrowing or leakiness is severe or the patient is experiencing symptoms. […] The most commonly performed procedure is aortic valve replacement, with either an artificial mechanical valve or a biological tissue valve. In certain cases of a leaky valve, repair of the aortic valve may be more feasible than replacement, which is more advantageous, especially in younger patients.

• #6 Mayo Clinic Q and A: Treatment and management of bicuspid aortic valve – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-treatment-and-management-of-bicuspid-aortic-valve/

  While there are no medications for bicuspid aortic valve, your health care provider may prescribe medications to treat associated heart problems, like high blood pressure. Patients with bicuspid aortic valve are at increased risk for developing infection of the lining of the heart and the valves, so recommendations for proper, regular dental care can lower this risk. […] In summary, once the diagnosis of bicuspid aortic valve is established, you will require lifelong care and surveillance by a cardiologist using an echocardiogram to monitor your valve and aorta.

• #7 Bicuspid Aortic Valve Causes, Symptoms, Treatments

  https://www.upmc.com/services/heart-vascular/conditions/bicuspid-aortic-valve

  Most people with bicuspid aortic valves need surgery in adulthood. Some children with severe aortic stenosis at birth, may need surgery right away. […] After you are diagnosed with a bicuspid aortic valve, your doctor will monitor your condition to watch for the development of valve disease and aortic aneurysm. […] Based on how complex your condition is, you may need valve repair or valve replacement surgery. Your doctor can advise you which type is right for you. Surgical treatment options include: […] If you have regurgitation that is, blood flowing back to the heart you may need valve repair surgery. […] The David procedure is a special type of valve repair for people who have an aortic root aneurysm and a valve that can be fixed. […] During this procedure, your surgeon: […] Some people who can’t have open-heart surgery may be a good fit for TAVR. This minimally invasive technique accesses the heart through a catheter inserted in an artery in the leg or groin. […] Aortic valve surgery is an effective treatment option for bicuspid aortic valve disease that is causing symptoms or complications.

• #8 Bicuspid aortic valve – Overview – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bicuspid-aortic-valve/cdc-20385577

  If you have a bicuspid aortic valve, you are usually sent to a doctor trained in congenital heart disease. This type of doctor is called a congenital cardiologist. […] Treatment for a bicuspid aortic valve depends on how severe the heart valve disease is. It may include medicines or a procedure or surgery to fix or replace the valve. […] There are no medicines to repair a bicuspid aortic valve. But medicines may be used to treat symptoms caused by heart valve disease. For example, your healthcare professional may recommend blood pressure medicine. […] Surgery may be needed if a bicuspid aortic valve is causing: Aortic valve stenosis. Aortic valve regurgitation. An enlarged aorta. […] Surgery is done to repair or replace the aortic valve. The type of surgery done depends on the specific heart valve condition and your symptoms.

• #9 Mayo Clinic Q and A: Treatment and management of bicuspid aortic valve – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-treatment-and-management-of-bicuspid-aortic-valve/

  While there are no medications for bicuspid aortic valve, your health care provider may prescribe medications to treat associated heart problems, like high blood pressure. Patients with bicuspid aortic valve are at increased risk for developing infection of the lining of the heart and the valves, so recommendations for proper, regular dental care can lower this risk. […] In summary, once the diagnosis of bicuspid aortic valve is established, you will require lifelong care and surveillance by a cardiologist using an echocardiogram to monitor your valve and aorta.

• #10 Bicuspid Aortic Disease | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/bicuspid-aortic-disease.html

  Treatment of bicuspid valve disease includes: […] Drugs to control blood pressure such as ACE inhibitors, ARBs, calcium channel blockers and beta blockers. This approach is designed to slow the enlargement of the aorta, reduce the risk of the aorta tearing or rupturing and to reduce the amount of blood flowing back into the heart through the valve. […] Lifestyle changes including eating a healthy, low-fat diet that is high in protein and fiber, maintaining a healthy weight, exercising regularly and quitting smoking and avoiding second hand smoke. […] Surgical approaches include replacing the diseased portion of the aorta with a Dacron graft or replacing the aortic valve with one that is either biological or mechanical. Usually the valve is replaced before it totally fails to avoid lasting damage to the heart.

• #11 Bicuspid aortic valve: Intervention for valve disease or aortopathy in adults – UpToDate

  https://www.uptodate.com/contents/bicuspid-aortic-valve-intervention-for-valve-disease-or-aortopathy-in-adults

  Bicuspid aortic valve: Intervention for valve disease or aortopathy in adults […] The bicuspid aortic valve (BAV) condition is a valvulo-aortopathy (affecting both the aortic valve and the thoracic aorta); therefore, its management in adults includes surveillance of aortic valve function and the thoracic aorta (the aortic root and ascending aorta), timely intervention, treatment of hypertension, measures to address the risk of infective endocarditis, counseling patients on physical activity, and management prior to and during pregnancy. Interventional management of valve disease and aortopathy in adults with BAV will be discussed here. […] Indications for prophylactic ascending aortic surgery for patients with bicuspid aortic valve.

• #12 Top 7 Facts: Bicuspid Aortic Valve Disease & Medications

  https://www.heart-valve-surgery.com/learning/bicuspid-aortic-valve-medications-drugs/

  Patients diagnosed with bicuspid aortic valve disease are often confused about the potential use of medication and/or cardiac surgery to treat this unique form of heart disease. […] For patients with mild forms of bicuspid aortic valves, medications can be used to help manage the aortic regurgitation. “Medication can be used, and very successfully, with mild cases of regurgitation,” states Dr. Castro. “What we try to do with medication is to lower blood pressure on the end where blood is trying to be expelled in, so that more blood ends up forward and less blood ends up coming back and returning to the heart. We can also – like a leaky faucet, if you will. If you’ve got a leaky valve and a leaky faucet, you turn down the water supply so that it leaks less. We can use diuretics which are medications that enhances urination and decrease the total volume of blood within the heart chamber so your valve is going to leak less.”

• #13 Bicuspid aortic valve : MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/007325.htm

  Your infant or child may need surgery to repair or replace a leaky or narrowed valve, if complications are severe. […] A narrowed valve can also be opened through cardiac catheterization. A fine tube (catheter) is directed to the heart and into the narrow opening of the aortic valve. A balloon attached to the end of the tube is inflated to make the opening of the valve larger. […] In adults, when a bicuspid valve becomes very leaky or very narrowed, it may need to be replaced. This used to be possible only with open heart surgery, but can now sometimes be done via catheters. […] Sometimes the aorta may also need to be repaired if it has become too wide or is too narrow. […] Medicine may be needed to relieve symptoms or prevent complications. Medicines may include: […] Medicines that lower the workload on the heart (beta-blockers, ACE inhibitors) […] Medicines that make the heart muscle pump harder (inotropic agents) […] Water pills (diuretics)

• #14 Bicuspid aortic valve : MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/007325.htm

  Your infant or child may need surgery to repair or replace a leaky or narrowed valve, if complications are severe. […] A narrowed valve can also be opened through cardiac catheterization. A fine tube (catheter) is directed to the heart and into the narrow opening of the aortic valve. A balloon attached to the end of the tube is inflated to make the opening of the valve larger. […] In adults, when a bicuspid valve becomes very leaky or very narrowed, it may need to be replaced. This used to be possible only with open heart surgery, but can now sometimes be done via catheters. […] Sometimes the aorta may also need to be repaired if it has become too wide or is too narrow. […] Medicine may be needed to relieve symptoms or prevent complications. Medicines may include: […] Medicines that lower the workload on the heart (beta-blockers, ACE inhibitors) […] Medicines that make the heart muscle pump harder (inotropic agents) […] Water pills (diuretics)

• #15 Bicuspid Aortic Valve Atorvastatin Treatment Study – BICATOR

  https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2024/06/17/14/18/BICATOR

  The BICATOR trial showed that in patients with bicuspid aortic valve, low to moderate dose atorvastatin was not associated with slower progression of ascending aortic dilation or valvular dysfunction compared with placebo. […] The goal of the trial was to determine whether treatment with low to moderate dose atorvastatin is associated with progression of ascending aortic dilation, valvular dysfunction, or valve calcification in patients with bicuspid aortic valve (BAV). […] The primary outcome, mean increase from baseline ascending aorta diameter at 3 years, for atorvastatin vs. placebo, was: 0.65 vs. 0.74 mm (p = 0.613). […] The current study demonstrated no change in progression of ascending aortic dilatation or AV calcification or hemodynamics after 3 years of low to moderate dose atorvastatin therapy. […] Moreover, atorvastatin was not associated with slower progression of AV calcification or the development of aortic stenosis or regurgitation.

• #16 Bicuspid aortic valve – Overview – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bicuspid-aortic-valve/cdc-20385577

  If you have a bicuspid aortic valve, you are usually sent to a doctor trained in congenital heart disease. This type of doctor is called a congenital cardiologist. […] Treatment for a bicuspid aortic valve depends on how severe the heart valve disease is. It may include medicines or a procedure or surgery to fix or replace the valve. […] There are no medicines to repair a bicuspid aortic valve. But medicines may be used to treat symptoms caused by heart valve disease. For example, your healthcare professional may recommend blood pressure medicine. […] Surgery may be needed if a bicuspid aortic valve is causing: Aortic valve stenosis. Aortic valve regurgitation. An enlarged aorta. […] Surgery is done to repair or replace the aortic valve. The type of surgery done depends on the specific heart valve condition and your symptoms.

• #17 Bicuspid Aortic Valve

  https://my.clevelandclinic.org/health/diseases/16780-bicuspid-aortic-valve-disease

  A bicuspid aortic valve can cause serious complications like heart failure. But with treatment, it wont affect your life expectancy and you can lead a healthy life. […] Bicuspid aortic valve disease treatment involves surgery for about 4 out of 5 people with this problem. Your surgeon will either repair or replace your aortic valve. […] Its important to have surgery early enough to prevent permanent damage to your heart. Even if you dont have symptoms, your provider may want to fix the problem now to avoid complications down the road. […] New technology continues to improve outcomes and reduce complications. Many people can have minimally invasive techniques instead of traditional open-heart surgery. […] Aortic valve repair fixes your valve without replacing it. It can be a good option for aortic regurgitation (leaky valve).

• #18 A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10531880/

  BAV presents complexities in its aetiology, with specific polymorphisms and gene disorders observed in groups with elevated BAV prevalence, contributing to increased susceptibility to other cardiovascular conditions. […] Employing TTE screening for first-degree relatives of BAV patients might be beneficial for disease tracking and enhancing clinical outcomes. […] While SAVR is the primary recommendation for indicated AVR in BAV, TAVR might be an option for certain patients endorsed by adept aortic teams. […] In addition, proficient teams can perform aortic valve repair for AR cases. […] Aortic surgery necessitates personalized evaluation, accounting for genetic makeup and risk factors. […] While the standard aortic replacement threshold stands at 55 mm, it may be tailored to 50 mm or even 45 mm based on patient-specific considerations.

• #19 A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10531880/

  However, it is evident that comprehensive, well-designed investigations supported by robust evidence are imperative to attain a more comprehensive understanding of this matter. […] In broad terms, aortic replacement is strongly recommended as a Class I intervention when the aortic diameter reaches or exceeds 55 mm. […] Nonetheless, both American and European guidelines exhibit a flexible approach when determining the threshold for surgical replacement or repair in cases involving BAV-associated aortopathy. […] The existence of distinct indication thresholds for various scenarios within BAV aortopathy highlights the significance of individualized assessment and strategic planning in addressing this intricate condition.

• #20 Bicuspid Aortic Valve

  https://my.clevelandclinic.org/health/diseases/16780-bicuspid-aortic-valve-disease

  A bicuspid aortic valve can cause serious complications like heart failure. But with treatment, it wont affect your life expectancy and you can lead a healthy life. […] Bicuspid aortic valve disease treatment involves surgery for about 4 out of 5 people with this problem. Your surgeon will either repair or replace your aortic valve. […] Its important to have surgery early enough to prevent permanent damage to your heart. Even if you dont have symptoms, your provider may want to fix the problem now to avoid complications down the road. […] New technology continues to improve outcomes and reduce complications. Many people can have minimally invasive techniques instead of traditional open-heart surgery. […] Aortic valve repair fixes your valve without replacing it. It can be a good option for aortic regurgitation (leaky valve).

• #21 Bicuspid aortic valve – Overview – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bicuspid-aortic-valve/cdc-20385577

  Aortic valve replacement. The surgeon removes the damaged valve. It’s replaced with a mechanical valve or a valve made from cow, pig or human heart tissue. The tissue valve is called a biological tissue valve. […] Balloon valvuloplasty. This procedure can treat aortic valve stenosis in infants and children. In adults, the aortic valve tends to narrow again after the procedure. So it’s usually only done if you’re too ill for surgery or you’re waiting for a valve replacement.

• #22 Bicuspid Aortic Valve

  https://my.clevelandclinic.org/health/diseases/16780-bicuspid-aortic-valve-disease

  Aortic valve replacement involves removing your unrepairable valve and giving you a new one. […] Many people prefer a biological valve so they dont have to take blood thinners. […] Generally, valve surgeries have a low risk of complications. […] It can take two to three months to recover completely from an aortic valve replacement. You may only need one to two months to recover from an aortic valve repair. […] About 98% of people who have valve surgery survive without it affecting their life expectancy. If you have a bicuspid aortic valve, you can live just as long as someone without this condition. But you need regular follow-ups and testing with your healthcare provider. Treatment is essential to avoiding complications.

• #23 A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10531880/

  The management of BAV presents a complex and critical challenge in cardiovascular medicine. […] Medical treatment options for BAV patients are limited, with more than half requiring AVR during their lifetime, and 25% undergoing aortic replacement surgery. […] For patients diagnosed with bicuspid aortic valve disease and an indication for AVR, current guidelines recommend surgical AVR (SAVR) with a class I recommendation, provided the patient is suitable for the procedure. […] However, ongoing research is shedding light on whether this surgical intervention will involve repair or replacement in cases of aortic regurgitation. […] A meta-analysis published in 2019, comparing replacement and repair in aortic regurgitation, revealed that the perioperative outcomes of repair were comparable to those of replacement.

• #24 Managing Aortic Stenosis Symptoms    | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-disease-risks-signs-and-symptoms/managing-aortic-stenosis-symptoms

  After general anesthesia is administered, a cardiothoracic surgeon makes an incision in the chest. Once the patient is placed on the heart-lung machine, the heart is opened and the diseased valve is removed. A new valve is then sewn into place. Following SAVR, patients are discharged in about one week from the hospital. […] Once it has been determined that your aortic valve needs to be replaced, your doctor will discuss treatment options to help you decide which valve replacement procedure is best for you. This discussion will include the risks and benefits of each procedure. Whichever procedure you choose, lifetime follow-up with a cardiologist is necessary to ensure that your replacement valve continues to function well over time.

• #25 Aortic Stenosis: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-stenosis/treatment

  Aortic valve stenosis treatment will depend on your symptoms and the severity of the condition. Your cardiology team will work closely with you to determine the best course of action based on your overall health and risk factors. In some cases, you can get aortic valve stenosis treatment without surgery. If you have mild aortic stenosis, treatment may be handled through medications or other nonsurgical methods. […] Surgery is sometimes necessary for severe aortic valve stenosis treatment. If your condition significantly impairs your heart function, your physician may recommend one of the following surgical procedures: […] Aortic valve replacement (AVR): AVR is a common treatment for severe aortic stenosis. During this open-heart procedure, the surgeon removes the damaged aortic valve and replaces it with a prosthetic valve. Prosthetic options include mechanical valves or valves made from human, cow, or pig tissue.

• #26 Bicuspid Aortic Valve

  https://my.clevelandclinic.org/health/diseases/16780-bicuspid-aortic-valve-disease

  Aortic valve replacement involves removing your unrepairable valve and giving you a new one. […] Many people prefer a biological valve so they dont have to take blood thinners. […] Generally, valve surgeries have a low risk of complications. […] It can take two to three months to recover completely from an aortic valve replacement. You may only need one to two months to recover from an aortic valve repair. […] About 98% of people who have valve surgery survive without it affecting their life expectancy. If you have a bicuspid aortic valve, you can live just as long as someone without this condition. But you need regular follow-ups and testing with your healthcare provider. Treatment is essential to avoiding complications.

• #27 Bicuspid Aortic Valve Program at Columbia | Columbia Surgery

  https://columbiasurgery.org/aortic/bicuspid-aortic-valve-program-columbia

  If you or someone you love needs treatment for a bicuspid aortic valve, you want to work with a team with a proven track record of providing the best outcomes. The Columbia Bicuspid Aortic Valve Program offers expert diagnosis and the most advanced treatments for bicuspid valve repair and replacement, including the latest minimally invasive treatments and cutting-edge surgical procedures. […] Our bicuspid valve team provides outstanding care for patients with bicuspid aortic valves and similar complex anatomy, as well as valvular and aortic disease related to their bicuspid valves. […] Treatments We Offer: Aortic valve replacement (Ross procedure), Valve-sparing aortic root replacement (David procedure), Composite graft replacement (Bentall procedure), Aortic root and ascending aorta surgery, Balloon valvuloplasty, Aortic valve repair, Mechanical and prosthetic valve replacement, Transcatheter aortic valve replacement (TAVR).

• #28 Aortic Stenosis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/aortic-stenosis

  Another option for aortic stenosis treatment includes a valve replacement. This can be done with either a tissue or mechanical valve. If this is the case, your child may need to stay on blood-thinning medicines for the rest of their life. […] Surgeons may decide a Ross Procedure is the best option to treat aortic stenosis. In this operation, the aortic valve is replaced with the patient’s native pulmonary valve. The pulmonary valve is then replaced with a valve from a donor. This procedure allows the patient’s new aortic valve to grow with the child. This does not require blood thinner. […] Subaortic and supravalvular stenosis do not improve with balloon dilation and will require heart surgery if the amount of obstruction is moderate or severe, or, in the case of subaortic stenosis, the aortic valve begins to leak significantly.

• #29 BAV: SAVR versus TAVR | aortopathy bicuspid aortic valve

  https://www.uscjournal.com/articles/bicuspid-aortic-stenosis-and-without-aortopathy-considerations-surgical-aortic-valve?language_content_entity=en

  The advantage of the Ross procedure is extended durability without the need for long-term anticoagulation. […] The use of SURD in BAV has been traditionally considered as contraindicated. However, this has been challenged, with multiple groups presenting data showing excellent results in BAV including Sievers type 0 valves. […] The international experience with SURD was reviewed in the SURD international registry, in which 191 patients out of 4,636 had BAV. […] The Ross procedure has waxed and waned in popularity, with a revival in recent years prompted by advancements in surgical technique. […] The use of the Ross procedure in BAV has multiple advantages in the younger patient population, with the avoidance of long-term anticoagulation, favorable hemodynamics and extended valve durability.

• #30 Mayo Clinic Q and A: Treatment and management of bicuspid aortic valve – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-treatment-and-management-of-bicuspid-aortic-valve/

  A new diagnosis of a bicuspid aortic valve usually does not require immediate intervention or have significant health effects in the short- or mid-term. It does require lifelong surveillance because it may cause heart problems in the long term. Over half of patients will need aortic valve repair or replacement within 25 years after bicuspid aortic valve diagnosis. […] Treatment of the bicuspid aortic valve depends on the extent of the valve’s disease, the patient’s symptoms and the size of the aorta. Open-heart surgery may be needed if the narrowing or leakiness is severe or the patient is experiencing symptoms. […] The most commonly performed procedure is aortic valve replacement, with either an artificial mechanical valve or a biological tissue valve. In certain cases of a leaky valve, repair of the aortic valve may be more feasible than replacement, which is more advantageous, especially in younger patients.

• #31 A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10531880/

  BAV presents complexities in its aetiology, with specific polymorphisms and gene disorders observed in groups with elevated BAV prevalence, contributing to increased susceptibility to other cardiovascular conditions. […] Employing TTE screening for first-degree relatives of BAV patients might be beneficial for disease tracking and enhancing clinical outcomes. […] While SAVR is the primary recommendation for indicated AVR in BAV, TAVR might be an option for certain patients endorsed by adept aortic teams. […] In addition, proficient teams can perform aortic valve repair for AR cases. […] Aortic surgery necessitates personalized evaluation, accounting for genetic makeup and risk factors. […] While the standard aortic replacement threshold stands at 55 mm, it may be tailored to 50 mm or even 45 mm based on patient-specific considerations.

• #32 A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10531880/

  The management of BAV presents a complex and critical challenge in cardiovascular medicine. […] Medical treatment options for BAV patients are limited, with more than half requiring AVR during their lifetime, and 25% undergoing aortic replacement surgery. […] For patients diagnosed with bicuspid aortic valve disease and an indication for AVR, current guidelines recommend surgical AVR (SAVR) with a class I recommendation, provided the patient is suitable for the procedure. […] However, ongoing research is shedding light on whether this surgical intervention will involve repair or replacement in cases of aortic regurgitation. […] A meta-analysis published in 2019, comparing replacement and repair in aortic regurgitation, revealed that the perioperative outcomes of repair were comparable to those of replacement.

• #33 Managing Bicuspid Aortic Valve Disease

  https://consultqd.clevelandclinic.org/bicuspid-aortic-valve-disease-multifaceted-challenges-demand-versatile-management

  In most cases, a bicuspid aortic valve (BAV) can be surgically treated very safely and effectively with or without root replacement even for severe regurgitation and accompanying aortic dilation and aneurysm. […] For aortic stenosis in patients with a BAV, the strategy is generally to surgically replace the valve, except in specific circumstances where the valve is also regurgitant and the leaflets are of sufficient quality to enable repair. […] Once surgery is decided on, issues surrounding replacement versus repair become paramount. The decision is based on patient age (repair is especially advantageous for younger patients) and preoperative and intraoperative clinical findings. Replacement is needed for patients with moderate to severe aortic stenosis. […] Systematic intraoperative assessment of commissures, leaflets, anulus, sinuses and sinutubular junction (CLASS) helps determine strategy and techniques. For patients with heavy calcification or major perforations of valve leaflets, replacement is recommended.

• #34 Aortic Valve Disease | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/aortic-valve-disease

  The Congenital Heart Valve Program at Boston Children’s specializes in the care and treatment of aortic valve disease. […] Our team carefully considers two primary approaches before treating aortic valve disease: aortic valve repair and aortic valve replacement. […] We believe children benefit when their heart valves can be repaired, rather than replaced. […] Here are four types of repair and reconstruction procedures we perform: Simple leaflet repair, Complex leaflet repairs/bicuspidization, Valve-sparing aortic root repair, Ozaki procedure. […] Unfortunately, some children have advanced tricuspid valve disease and repairs aren’t enough. They instead need a replacement valve. […] Here are four types of aortic valve replacement procedures we perform: Bioprosthetic aortic valve replacement, Aortic homografts/allograft aortic valve replacement, Mechanical aortic valve replacement, Ross procedure, Partial heart transplant.

• #35 A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10531880/

  Notably, in the context of the bicuspid valve, a 2016 meta-analysis emphasized the potential feasibility and optimism associated with repair as a viable option. […] In the European and American guidelines, it has been suggested that aortic valve repair in AR can be performed in accordance with the multidisciplinary team decision of experienced surgeons in experienced aortic centres, as a class IIb, level of evidence C recommendation. […] Transcatheter AVR (TAVR) stands as a robust option in high- and intermediate-risk patient cohorts, yet considerable challenges arise within the context of BAV patients. […] The introduction of rapid deployment valves is geared towards streamlining surgical procedures and mitigating potential risks, offering a prospective substitute to traditional valve options.

• #36 Bicuspid Aortic Valve

  https://my.clevelandclinic.org/health/diseases/16780-bicuspid-aortic-valve-disease

  Aortic valve replacement involves removing your unrepairable valve and giving you a new one. […] Many people prefer a biological valve so they dont have to take blood thinners. […] Generally, valve surgeries have a low risk of complications. […] It can take two to three months to recover completely from an aortic valve replacement. You may only need one to two months to recover from an aortic valve repair. […] About 98% of people who have valve surgery survive without it affecting their life expectancy. If you have a bicuspid aortic valve, you can live just as long as someone without this condition. But you need regular follow-ups and testing with your healthcare provider. Treatment is essential to avoiding complications.

• #37 Bicuspid Aortic Valve > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/bicuspid-aortic-valve

  Treatment includes medications, lifestyle changes, surgery, and other medical procedures. […] Treatment for bicuspid aortic valves may include: […] If a bicuspid aortic valve is working well, isnt causing any symptoms, and doesnt show signs of complications, treatment isnt necessary. […] For people with high blood pressure, medications that help lower blood pressure are typically part of treatment. […] People who have a well-functioning bicuspid aortic valve can safely exercise and participate in physical activities, including high-intensity sports. […] For people with a poorly functioning bicuspid aortic valve who do not also have a widening of the aorta, surgery may be needed to repair or replace the bicuspid aortic valve. […] For people with a dilated aorta but whose aortic valve is functioning well, a surgeon may repair the aorta and leave the aortic valve in place. […] For people with a poorly functioning bicuspid aortic valve and dilated aorta, surgery may be necessary repair or replace the aortic valve and repair the aorta. […] This procedure may be used to treat people with aortic stenosis. […] TAVR may be an option for people with aortic stenosis.

• #38 A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10531880/

  However, it is evident that comprehensive, well-designed investigations supported by robust evidence are imperative to attain a more comprehensive understanding of this matter. […] In broad terms, aortic replacement is strongly recommended as a Class I intervention when the aortic diameter reaches or exceeds 55 mm. […] Nonetheless, both American and European guidelines exhibit a flexible approach when determining the threshold for surgical replacement or repair in cases involving BAV-associated aortopathy. […] The existence of distinct indication thresholds for various scenarios within BAV aortopathy highlights the significance of individualized assessment and strategic planning in addressing this intricate condition.

• #39 Bicuspid aortic valve

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-13/Bicuspid-aortic-valve

  However, there is a possible role of beta blockers and ARBs in delaying progression of aortic dilatation, extrapolating from patients with aortopathy associated with Marfans syndrome, but have not been confirmed in clinical studies. […] The recent ESC guidelines for valvular heart disease management recommend that surgery should be considered for any patient with aortic root diameter of 55 mm. […] However, in patients with BAV, surgery in aortic diameters of 50 mm should be based on patient age, body size, comorbidities, type of surgery, and the presence of additional risk factors – family history, systemic hypertension, coarctation of the aorta, or increase in aortic diameter 2 mm/year in repeated examinations using the same technique and confirmed by another technique. […] The new ACC/AHA guidelines recommend surgical repair of aortic root if aortic root diameter is 5.5 cm (Class I).

• #40 Bicuspid Aortic Valve Program at Columbia | Columbia Surgery

  https://columbiasurgery.org/aortic/bicuspid-aortic-valve-program-columbia

  If you or someone you love needs treatment for a bicuspid aortic valve, you want to work with a team with a proven track record of providing the best outcomes. The Columbia Bicuspid Aortic Valve Program offers expert diagnosis and the most advanced treatments for bicuspid valve repair and replacement, including the latest minimally invasive treatments and cutting-edge surgical procedures. […] Our bicuspid valve team provides outstanding care for patients with bicuspid aortic valves and similar complex anatomy, as well as valvular and aortic disease related to their bicuspid valves. […] Treatments We Offer: Aortic valve replacement (Ross procedure), Valve-sparing aortic root replacement (David procedure), Composite graft replacement (Bentall procedure), Aortic root and ascending aorta surgery, Balloon valvuloplasty, Aortic valve repair, Mechanical and prosthetic valve replacement, Transcatheter aortic valve replacement (TAVR).

• #41 Managing Bicuspid Aortic Valve Disease

  https://consultqd.clevelandclinic.org/bicuspid-aortic-valve-disease-multifaceted-challenges-demand-versatile-management

  Dr. Lou emphasizes the imperative to ensure that results are optimal with good function and no leakage, as determined visually and with intraoperative echocardiography before closing the incision. […] A study comparing Cleveland Clinic patients who underwent aortic root replacement with either BAV reimplantation (n = 92) or tricuspid aortic valve reimplantation (n = 515) from 2002 to 2017 found similar short-term and five-year outcomes among 71 matched pairs. […] However, higher gradients, less ventricular reverse remodeling and more aortic valve reoperations in the BAV group indicated a need for continued surveillance in such patients. […] Another Cleveland Clinic study analyzed more than two decades of data (1998-2020) from patients who underwent BAV repair with (n = 419) or without (n = 421) ascending aorta replacement.

• #42 Managing Bicuspid Aortic Valve Disease

  https://consultqd.clevelandclinic.org/bicuspid-aortic-valve-disease-multifaceted-challenges-demand-versatile-management

  At 10 years, across the overall cohort, survival was 95% after BAV repair with aorta replacement and 96% after BAV repair alone, and rates of freedom from reoperation were 79% and 75%, respectively. […] Dr. Lou notes that an important focus of the study was to determine the importance of replacing the ascending aorta with a tube graft for the sole purpose of stabilizing the sinutubular junction (STJ). […] Both Drs. Lou and Griffin emphasize that with the number of considerations surrounding surgery for BAV disease, decisions are best made with the input of the full heart care team.

• #43 Managing Aortic Stenosis Symptoms    | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-disease-risks-signs-and-symptoms/managing-aortic-stenosis-symptoms

  Severe AS, sometimes referred to as a failing heart valve, is a life-threatening condition. The treatment for severe AS is aortic valve replacement. This is accomplished either through the open-heart surgery SAVR (surgical aortic valve replacement) or the less invasive procedure called TAVI or TAVR (transcatheter aortic valve implantation or transcatheter aortic valve replacement). Although SAVR has traditionally been the standard for treating severe AS, TAVI is now available to most patients. […] After aortic valve replacement, you can expect your symptoms to resolve and to have an improved quality of life. […] During a TAVI procedure, an interventional cardiologist inserts a replacement valve through an artery in the groin or chest area. The new valve is guided through the artery into the heart to the position of the diseased aortic valve. Once in place, a balloon is expanded, and the new valve becomes implanted. TAVI may be performed with sedation or general anesthesia. Patients are often discharged from the hospital within a few days. Time in the hospital following TAVI is dependent on many factors, including age and the presence of other medical conditions.

• #44 Managing Aortic Stenosis Symptoms    | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-disease-risks-signs-and-symptoms/managing-aortic-stenosis-symptoms

  After general anesthesia is administered, a cardiothoracic surgeon makes an incision in the chest. Once the patient is placed on the heart-lung machine, the heart is opened and the diseased valve is removed. A new valve is then sewn into place. Following SAVR, patients are discharged in about one week from the hospital. […] Once it has been determined that your aortic valve needs to be replaced, your doctor will discuss treatment options to help you decide which valve replacement procedure is best for you. This discussion will include the risks and benefits of each procedure. Whichever procedure you choose, lifetime follow-up with a cardiologist is necessary to ensure that your replacement valve continues to function well over time.

• #45 Transcatheter Aortic Valve Therapy for Bicuspid Aortic Valve Stenosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10607300/

  Transcatheter aortic valve implantation (TAVI) has become first-line treatment for older adults with severe aortic stenosis (AS), however, patients with bicuspid aortic valve (BAV) have been traditionally excluded from randomised trials and guidelines. […] As familiarity and proficiency of TAVI operators have improved, case-series and observational data have demonstrated the feasibility of successful TAVI in bicuspid aortic valve aortic stenosis (BAV-AS), however, patients with BAV-AS have several distinct characteristics that influence the likelihood of TAVI success. […] Surgical AVR has long been considered the preferred treatment for bicuspid aortic valve aortic stenosis (BAV-AS), however, as transcatheter heart valve (THV) technology has improved and transcatheter aortic valve implantation (TAVI) centres have matured, TAVI has emerged as a safe and feasible treatment for selected patients with BAV-AS.

• #46 Bicuspid aortic valve

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-13/Bicuspid-aortic-valve

  Bicuspid aortic valve may be complicated with aortic valve stenosis and/or regurgitation in addition to risk of endocarditis. […] The definitive treatment is surgery for the valve and/or aortic root depending on severity of valve lesion, aortic diameter and rate of progression of aortopathy. […] Aortic valve replacement is the only definitive treatment for BAV associated with severe stenosis and/or regurgitation. […] New techniques of repair such as transcatheter aortic valve implantation have also been reported in BAV but are still considered as a relative contraindication in recent guidelines. […] In patients who refuse surgery or are not candidates for surgical intervention, medical therapy is limited and is mainly used to treat existent cardiac conditions such as heart failure, coronary artery disease or hypertension.

• #47 Transcatheter Aortic Valve Therapy for Bicuspid Aortic Valve Stenosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10607300/

  Transcatheter aortic valve implantation (TAVI) has become first-line treatment for older adults with severe aortic stenosis (AS), however, patients with bicuspid aortic valve (BAV) have been traditionally excluded from randomised trials and guidelines. […] As familiarity and proficiency of TAVI operators have improved, case-series and observational data have demonstrated the feasibility of successful TAVI in bicuspid aortic valve aortic stenosis (BAV-AS), however, patients with BAV-AS have several distinct characteristics that influence the likelihood of TAVI success. […] Surgical AVR has long been considered the preferred treatment for bicuspid aortic valve aortic stenosis (BAV-AS), however, as transcatheter heart valve (THV) technology has improved and transcatheter aortic valve implantation (TAVI) centres have matured, TAVI has emerged as a safe and feasible treatment for selected patients with BAV-AS.

• #48 Study Finds TAVR is Safe Treatment for Patients with Bicuspid Valve Disease

  https://www.acc.org/about-acc/press-releases/2020/05/27/14/25/study-finds-tavr-is-safe-treatment-for-patients-with-bicuspid-valve-disease

  Study Finds TAVR is Safe Treatment for Patients with Bicuspid Valve Disease […] For many patients with a bicuspid aortic valve that needs replacing, transcatheter aortic valve replacement (TAVR) appears to be a safe treatment option with low complication rates, according to a study published in JACC: Cardiovascular Interventions. […] This study suggests TAVR is a viable option for patients with bicuspid valve disease who are at increased surgical risk, Forrest said.

• #49 A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10531880/

  BAV presents complexities in its aetiology, with specific polymorphisms and gene disorders observed in groups with elevated BAV prevalence, contributing to increased susceptibility to other cardiovascular conditions. […] Employing TTE screening for first-degree relatives of BAV patients might be beneficial for disease tracking and enhancing clinical outcomes. […] While SAVR is the primary recommendation for indicated AVR in BAV, TAVR might be an option for certain patients endorsed by adept aortic teams. […] In addition, proficient teams can perform aortic valve repair for AR cases. […] Aortic surgery necessitates personalized evaluation, accounting for genetic makeup and risk factors. […] While the standard aortic replacement threshold stands at 55 mm, it may be tailored to 50 mm or even 45 mm based on patient-specific considerations.

• #50 Transcatheter Aortic Valve Therapy for Bicuspid Aortic Valve Stenosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10607300/

  Current adult guidelines recommend consideration of standalone BV only as a bridge to TAVI in patients with decompensated heart failure or shock or to facilitate urgent non-cardiac surgery or childbirth. […] Initial feasibility of BAV-TAVI was demonstrated by small case series. […] Over time, data emerged regarding the safety of TAVI in carefully selected BAV-AS patients at low surgical risk. […] Randomised data comparing TAVI to surgical AVR in bicuspid AS are lacking, as BAV patients were excluded from all landmark TAVI RCTs. […] The risk of coronary obstruction is a major determinant of THV choice, both for the index procedure and any subsequent valve-in-valve TAVI procedures. […] Both balloon-expanding valve (BEV) and self-expanding valve (SEV) prostheses have been demonstrated to be safe in BAV-TAVI, and patient anatomical characteristics should be considered during THV selection. […] While pioneering operators have demonstrated the feasibility and overall safety of TAVI in patients with BAV, many questions remain unanswered.

• #51 Treating Aortic Valve Stenosis Without Surgery

  https://www.healthline.com/health/heart/aortic-valve-stenosis-treatment-without-surgery

  Another less-invasive procedure is called transcatheter aortic valve replacement (TAVR). This is a catheter-based procedure performed to replace the stenotic valve. […] The length of hospital stay is generally less than with the other open-heart surgery, with some lower-risk patients being able to leave the hospital the day after the procedure. […] Treating aortic valve stenosis without surgery is an increasingly common approach for people of all ages. Catheter-based procedures, particularly TAVR, are less invasive than open-heart surgery, allowing for a shorter, easier recovery. […] And because health outcomes are comparable between surgery and TAVR, its important to discuss nonsurgical treatment with your doctor if your aortic valve needs to be replaced.

• #52 Bicuspid Aortic Valve

  https://my.clevelandclinic.org/health/diseases/16780-bicuspid-aortic-valve-disease

  A bicuspid aortic valve can cause serious complications like heart failure. But with treatment, it wont affect your life expectancy and you can lead a healthy life. […] Bicuspid aortic valve disease treatment involves surgery for about 4 out of 5 people with this problem. Your surgeon will either repair or replace your aortic valve. […] Its important to have surgery early enough to prevent permanent damage to your heart. Even if you dont have symptoms, your provider may want to fix the problem now to avoid complications down the road. […] New technology continues to improve outcomes and reduce complications. Many people can have minimally invasive techniques instead of traditional open-heart surgery. […] Aortic valve repair fixes your valve without replacing it. It can be a good option for aortic regurgitation (leaky valve).

• #53 TAVR for Bicuspid Aortic Valve Disease – Cardiac Interventions Today

  https://citoday.com/articles/2020-mar-apr/tavr-for-bicuspid-aortic-valve-disease

  However, several other observational studies comparing TAVR outcomes in patients with BAV and trileaflet AS showed no difference in mortality, prompting continued exploration of TAVR as a treatment option for selected patients with bicuspid valves. […] With improved patient selection and advances in preprocedural imaging, deployment technique, and device technology, more recent BAV TAVR registries have reported significantly improved procedural outcomes and mortality. […] The more favorable results of the recent BAV TAVR registries may be due at least in part to the use of newer-generation THVs. […] Despite the apparent improvement in results with new-generation THV systems, contemporary registries and meta-analyses continue to show that TAVR for bicuspid valve disease may be associated with higher rates of certain complications.

• #54 Transcatheter Aortic Valve Therapy for Bicuspid Aortic Valve Stenosis

  https://www.mdpi.com/2308-3425/10/10/421

  These data suggest short-term safety in a carefully selected cohort of BAV, however, significant details were lacking including type of THV and rate of moderate or greater PVR. […] When selecting patients with BAV-AS appropriate for TAVI, a series of key factors must be considered. […] The most recent major guidelines recommend aortic replacement in patients with severe BAV-AS where ascending aorta diameter exceeds 4.5 mm. […] BAV-AS patients with a calcified raphe and with high volume of leaflet calcification have an increased risk of all-cause mortality following TAVI, with higher rates of aortic root injury and moderate or severe para-valvular leak.

• #55 Transcatheter Aortic Valve Therapy for Bicuspid Aortic Valve Stenosis

  https://www.mdpi.com/2308-3425/10/10/421

  Surgical AVR has long been considered the preferred treatment for bicuspid aortic valve aortic stenosis (BAV-AS), however, as transcatheter heart valve (THV) technology has improved and transcatheter aortic valve implantation (TAVI) centres have matured, TAVI has emerged as a safe and feasible treatment for selected patients with BAV-AS. […] Current adult guidelines recommend consideration of standalone BV only as a bridge to TAVI in patients with decompensated heart failure or shock or to facilitate urgent non-cardiac surgery or childbirth. […] Over time, data emerged regarding the safety of TAVI in carefully selected BAV-AS patients at low surgical risk. […] The Low Risk Bicuspid Study published by Forrest et al. was a single-arm prospective study enrolling 150 low-risk patients with BAV-AS with <3% predicted 30-day operative mortality, excluding those with aortopathy, prohibitive LVOT calcification or aged < 60 years old.

• #56 Bicuspid aortic valve – Overview – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bicuspid-aortic-valve/cdc-20385577

  Aortic valve replacement. The surgeon removes the damaged valve. It’s replaced with a mechanical valve or a valve made from cow, pig or human heart tissue. The tissue valve is called a biological tissue valve. […] Balloon valvuloplasty. This procedure can treat aortic valve stenosis in infants and children. In adults, the aortic valve tends to narrow again after the procedure. So it’s usually only done if you’re too ill for surgery or you’re waiting for a valve replacement.

• #57 Bicuspid Aortic Valve Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/893523-treatment

  No specific medical care is required for individuals with bicuspid aortic valve unless they have progressive deterioration or infection. […] Surgery specifically for bicuspid aortic valve is not necessary unless progressive complications ensue (valve regurgitation, valve stenosis, progressive aortic root dilatation, bacterial endocarditis). […] Bicuspid aortic valve without significant stenosis or insufficiency does not require any intervention; however, significant stenosis should be addressed. […] The treatment of congenital aortic valve stenosis was by surgical valvotomy in the past, but with the advent of balloon aortic valvuloplasty, it has become the initial option in the management of congenital aortic stenosis. […] Balloon aortic valvuloplasty is as good a treatment option for adolescents and adults with congenital aortic valve stenosis as for neonates, infants and children.

• #58 Bicuspid Aortic Valve (BAV) | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/bicuspid-aortic-valve

  […] […] Transcatheter balloon valvuloplasty that happens during a heart catheterization involves the insertion of a catheter with an uninflated balloon into the narrowed/constricted (stenotic) valve opening. The balloon is then inflated, then deflated, and removed. This procedure is used to relieve the narrowing/constriction of aortic valve. […] […] […] Valve Repair: The valve is tightened with stitched to reduce leaking. […] […] […] Mechanical Valve Replacement: Bicuspid valve is removed and is replaced with a mechanical valve. […] […] […] Tissue Valve (Bioprosthetic) Replacement: Bicuspid valve is removed and replaced with cadaver or animal tissue valve. […] […] […] David Procedure or Valve-Sparing Aortic Root Replacement: Ascending aorta is removed above valve, a vascular graft replaces the aorta, coronary arteries are attached to graft.

• #59 Aortic Stenosis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/aortic-stenosis

  Treatment for aortic stenosis depends on a child’s unique heart anatomy. Trivial and mild aortic stenosis typically do not require treatment. Moderate, severe and critical aortic stenosis, however, do require treatment which may include one or more of the following options: […] In most cases, aortic stenosis can be treated with a balloon valvuloplasty, which requires cardiac catheterization. An interventional cardiologist will insert a thin tube (catheter) into an artery in the leg, then guide the tube through the body, across the aortic valve and into your child’s heart. […] Repairing or replacing a faulty or blocked heart valve may be necessary in severe cases. Depending on your child’s age, needs and valve anatomy, physicians may attempt to repair the valve or improve its function with a procedure called a valvuloplasty.

• #60 Transcatheter Aortic Valve Therapy for Bicuspid Aortic Valve Stenosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10607300/

  Current adult guidelines recommend consideration of standalone BV only as a bridge to TAVI in patients with decompensated heart failure or shock or to facilitate urgent non-cardiac surgery or childbirth. […] Initial feasibility of BAV-TAVI was demonstrated by small case series. […] Over time, data emerged regarding the safety of TAVI in carefully selected BAV-AS patients at low surgical risk. […] Randomised data comparing TAVI to surgical AVR in bicuspid AS are lacking, as BAV patients were excluded from all landmark TAVI RCTs. […] The risk of coronary obstruction is a major determinant of THV choice, both for the index procedure and any subsequent valve-in-valve TAVI procedures. […] Both balloon-expanding valve (BEV) and self-expanding valve (SEV) prostheses have been demonstrated to be safe in BAV-TAVI, and patient anatomical characteristics should be considered during THV selection. […] While pioneering operators have demonstrated the feasibility and overall safety of TAVI in patients with BAV, many questions remain unanswered.

• #61 Bicuspid aortic valve – Overview – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bicuspid-aortic-valve/cdc-20385577

  Aortic valve replacement. The surgeon removes the damaged valve. It’s replaced with a mechanical valve or a valve made from cow, pig or human heart tissue. The tissue valve is called a biological tissue valve. […] Balloon valvuloplasty. This procedure can treat aortic valve stenosis in infants and children. In adults, the aortic valve tends to narrow again after the procedure. So it’s usually only done if you’re too ill for surgery or you’re waiting for a valve replacement.

• #62 Aortic Stenosis: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-stenosis/treatment

  Transcatheter aortic valve replacement (TAVR): TAVR is a less invasive treatment option for severe aortic valve stenosis. In this procedure, a catheter is inserted through a blood vessel to implant a new valve within the diseased aortic valve. TAVR is often an option for patients with severe aortic stenosis, including those at high risk or ineligible for open-heart surgery. […] Balloon valvuloplasty: In this procedure, a balloon is inflated to widen the narrowed aortic valve. While it doesn’t replace the valve, it can temporarily relieve symptoms, especially for those who aren’t candidates for valve replacement surgery. […] For the best outcome, it’s essential to follow your prescribed aortic stenosis therapy plan, take medications as directed, and attend all follow-up appointments with your physician.

• #63 Bicuspid aortic valve | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/bicuspid-aortic-valve?content_id=CON-20359710

  Biological tissue valves break down over time. They may eventually need to be replaced. If you have a mechanical valve, you need to take blood thinners for life to prevent blood clots. […] Balloon valvuloplasty. This procedure can treat aortic valve stenosis in infants and children. In adults, the aortic valve tends to narrow again after the procedure. So it’s usually only done if you’re too ill for surgery or you’re waiting for a valve replacement. […] This heart valve treatment uses a thin, flexible tube called a catheter. The catheter has a balloon on the tip. The surgeon inserts the catheter into an artery in the arm or groin. Then the catheter is guided to the aortic valve. Once in place, the balloon inflates, making the valve opening bigger. The balloon is deflated. The catheter and balloon are removed.

• #64 Bicuspid Aortic Disease | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/bicuspid-aortic-disease.html

  Treatment of bicuspid valve disease includes: […] Drugs to control blood pressure such as ACE inhibitors, ARBs, calcium channel blockers and beta blockers. This approach is designed to slow the enlargement of the aorta, reduce the risk of the aorta tearing or rupturing and to reduce the amount of blood flowing back into the heart through the valve. […] Lifestyle changes including eating a healthy, low-fat diet that is high in protein and fiber, maintaining a healthy weight, exercising regularly and quitting smoking and avoiding second hand smoke. […] Surgical approaches include replacing the diseased portion of the aorta with a Dacron graft or replacing the aortic valve with one that is either biological or mechanical. Usually the valve is replaced before it totally fails to avoid lasting damage to the heart.

• #65 Bicuspid aortic valve: What to avoid

  https://www.medicalnewstoday.com/articles/bicuspid-aortic-valve-what-to-avoid

  A person can help manage a bicuspid aortic valve by maintaining heart-healthy lifestyle habits and receiving medical treatment. […] There is currently no medical treatment that can prevent or slow the progression of BAV into aortic stenosis or aortic regurgitation. […] Medication may help manage the symptoms of the condition. A doctor may prescribe: diuretics, vasodilators, beta-blockers, angiotensin receptor blockers, angiotensin-converting enzyme inhibitors. […] If BAV becomes severe or complications occur, a person may require surgery. This involves surgeons either repairing or replacing the aortic valve. […] A person with BAV can help manage their condition by avoiding foods that contribute to heart damage and strain, such as products that contain excess salt, added sugars, and saturated fats.

• #66 Bicuspid Aortic Valve Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/893523-treatment

  Given the recent enthusiasm for transcatheter aortic valve replacement (TAVR), it should be emphasized that the TAVR should be reserved for severe calcific stenosis of the elderly. […] For noncardiac procedures, preoperative cardiac evaluation may be appropriate, particularly for patients with aortic stenosis or regurgitation. […] Because hypercholesterolemia and other coronary artery disease risk factors may accelerate the sclerosis and deterioration of a congenitally bicuspid aortic valve, a heart-healthy diet is recommended for all patients, not only those with recognized risk factors. […] Patients with normally functioning bicuspid aortic valves (ie, no stenosis or regurgitation) do not require activity restrictions. […] Patients who develop valve regurgitation or stenosis from a congenitally bicuspid aortic valve may require restrictions from strenuous competitive sports. […] Patients with aortic valve regurgitation should avoid strenuous isometric activity, such as weight lifting, rope climbing, and pull-ups.

• #67 Mayo Clinic Q and A: Treatment and management of bicuspid aortic valve – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-treatment-and-management-of-bicuspid-aortic-valve/

  While there are no medications for bicuspid aortic valve, your health care provider may prescribe medications to treat associated heart problems, like high blood pressure. Patients with bicuspid aortic valve are at increased risk for developing infection of the lining of the heart and the valves, so recommendations for proper, regular dental care can lower this risk. […] In summary, once the diagnosis of bicuspid aortic valve is established, you will require lifelong care and surveillance by a cardiologist using an echocardiogram to monitor your valve and aorta.

• #68 Bicuspid Aortic Valve Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/893523-treatment

  Given the recent enthusiasm for transcatheter aortic valve replacement (TAVR), it should be emphasized that the TAVR should be reserved for severe calcific stenosis of the elderly. […] For noncardiac procedures, preoperative cardiac evaluation may be appropriate, particularly for patients with aortic stenosis or regurgitation. […] Because hypercholesterolemia and other coronary artery disease risk factors may accelerate the sclerosis and deterioration of a congenitally bicuspid aortic valve, a heart-healthy diet is recommended for all patients, not only those with recognized risk factors. […] Patients with normally functioning bicuspid aortic valves (ie, no stenosis or regurgitation) do not require activity restrictions. […] Patients who develop valve regurgitation or stenosis from a congenitally bicuspid aortic valve may require restrictions from strenuous competitive sports. […] Patients with aortic valve regurgitation should avoid strenuous isometric activity, such as weight lifting, rope climbing, and pull-ups.

• #69 Bicuspid Aortic Valve: Diagnosis, Treatment, and Outlook

  https://www.healthline.com/health/heart-disease/bicuspid-aortic-valve

  If aortic regurgitation is the problem, valve repair may be possible, often with a catheter. During the procedure, a surgeon reshapes the valve to have three leaflets that can open and close more effectively. […] After aortic valve surgery, your doctor may advise you to participate in cardiac rehabilitation, a 12-week program that teaches diet, exercise, and lifestyle strategies to support heart health. […] Newer developments, such as transcatheter aortic valve implantation (TAVI), are improving survival and quality of life in people with bicuspid aortic valves and other similar conditions. […] The key is to be proactive about your heart health and get multiple opinions, if appropriate, about when surgery may be the best approach to preserve aortic valve function.

• #70 Bicuspid Aortic Valve

  https://my.clevelandclinic.org/health/diseases/16780-bicuspid-aortic-valve-disease

  A bicuspid aortic valve can cause serious complications like heart failure. But with treatment, it wont affect your life expectancy and you can lead a healthy life. […] Bicuspid aortic valve disease treatment involves surgery for about 4 out of 5 people with this problem. Your surgeon will either repair or replace your aortic valve. […] Its important to have surgery early enough to prevent permanent damage to your heart. Even if you dont have symptoms, your provider may want to fix the problem now to avoid complications down the road. […] New technology continues to improve outcomes and reduce complications. Many people can have minimally invasive techniques instead of traditional open-heart surgery. […] Aortic valve repair fixes your valve without replacing it. It can be a good option for aortic regurgitation (leaky valve).

• #71 Evolving treatment options for valve and aortic disease with bicuspid aortic valve

  https://atm.amegroups.org/article/view/14868/html

  Recently Schneider et al. reported excellent 10- and 15-year results for valve repair with root remodeling in a cohort of 357 younger patients with BAV and aortic root dilation. The majority of the patients included had both aortic aneurysm and significant aortic regurgitation. They discuss three key advances in their two decades of experience with this operation: (I) emphasis on effective cusp height, or the difference between the central free margins and the aortic insertion lines, being at least 8 mm after repair; (II) alteration of commissural orientation with root replacement to create near symmetric tongues (approaching 180) in appropriate cases; and (III) adding suture annuloplasty to root replacement in order to improve valvular competency. The common theme for all three of these surgical advances is the approximation of normal, symmetric aortic valve function. Schneider et al. report a cumulative incidence of reoperation of 22% at 15 years, which is better than data reported for bioprosthetic aortic valves.

• #72 Evolving treatment options for valve and aortic disease with bicuspid aortic valve

  https://atm.amegroups.org/article/view/14868/html

  While root dilation and aortic insufficiency are important manifestations of BAV disease, aortic stenosis and aneurysm of the mid-ascending aorta are more common. Data suggests that the majority of patients with BAV eventually develop aortic stenosis, and that dilation of the tubular ascending aorta is more than twice as common as isolated root dilation. Given the marked thickening, calcification and restriction of leaflet motion seen with BAV stenosis, the valve repair discussed by Schneider at al. is not a viable option for most cases of stenotic BAV. In fact, they caution that calcified plaques are a strong predictor for development of aortic stenosis, and that this should be factored into patient selection for their valve-sparing operation. […] One option that has gained ground in recent years is transcatheter aortic valve replacement (TAVR). It is now a more common procedure in Germany that surgical aortic valve replacement (SAVR), has a role for the treatment of intermediate-risk patients, and has been used for stenotic BAV with good short- and intermediate-term results. The role of TAVR in low-risk populations is currently being investigated, and while early results have been promising, the approach remains controversial. The long-term results of TAVR are unknown, and questions of durability are particularly important for younger patients with BAV that will likely require more than one valve intervention. Having said this, TAVR in younger patients with stenotic BAV provides a strategy to improve quality of life by avoiding life-long anticoagulation and delaying the need for open surgery. Recent studies have shown that repeat TAVR is feasible and associated with favorable early and mid-term outcomes, suggesting that the transcatheter approach may be a durable option for younger patients with BAV in the future.

• #73 A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10531880/

  Notably, in the context of the bicuspid valve, a 2016 meta-analysis emphasized the potential feasibility and optimism associated with repair as a viable option. […] In the European and American guidelines, it has been suggested that aortic valve repair in AR can be performed in accordance with the multidisciplinary team decision of experienced surgeons in experienced aortic centres, as a class IIb, level of evidence C recommendation. […] Transcatheter AVR (TAVR) stands as a robust option in high- and intermediate-risk patient cohorts, yet considerable challenges arise within the context of BAV patients. […] The introduction of rapid deployment valves is geared towards streamlining surgical procedures and mitigating potential risks, offering a prospective substitute to traditional valve options.

• #74 Evolving treatment options for valve and aortic disease with bicuspid aortic valve

  https://atm.amegroups.org/article/view/14868/html

  Another potential advantage of TAVR for stenotic BAV is more favorable systolic flow patterns in the ascending aorta. Bicuspid aortic valves produce distinctive helical blood flow patterns within the aorta, a finding that supports the importance of hemodynamics in the progressive aortopathy seen with BAV. While valve replacement improves transvalvular gradients and relieves patient symptoms, studies using advanced three-dimensional MRI blood flow imaging (4D Flow) have shown that ascending aortic flow patterns remain markedly abnormal despite aortic valve replacement. Furthermore, when comparing SAVR and TAVR techniques, the degree of helical and vertical flow in the ascending aorta is less with TAVR, despite both prostheses being constructed around a stented frame. The underlying cause of these differences remains unclear, but considering that eccentric flow has been proposed as a driver of ascending aortic growth, these findings suggest that TAVR may reduce rates of progressive BAV aortopathy via reduced flow abnormality. If future studies demonstrate long-term valve durability and function to be equal between SAVR and TAVR, the technique that minimizes abnormal blood flow in the ascending aorta may be best suited for a younger BAV population that is subject to high rates of ascending aortic disease. Similarly, among patients with insufficient BAVs for whom valve repair and root remodeling are undertaken, the techniques described by Schneider et al. may reduce the hemodynamic impact on the ascending aorta, given their emphasis on stabilizing the aortic root as well as increasing cusp and commissural symmetry.

• #75 Managing Bicuspid Aortic Valve Disease

  https://consultqd.clevelandclinic.org/bicuspid-aortic-valve-disease-multifaceted-challenges-demand-versatile-management

  At 10 years, across the overall cohort, survival was 95% after BAV repair with aorta replacement and 96% after BAV repair alone, and rates of freedom from reoperation were 79% and 75%, respectively. […] Dr. Lou notes that an important focus of the study was to determine the importance of replacing the ascending aorta with a tube graft for the sole purpose of stabilizing the sinutubular junction (STJ). […] Both Drs. Lou and Griffin emphasize that with the number of considerations surrounding surgery for BAV disease, decisions are best made with the input of the full heart care team.

• #76 BAV: SAVR versus TAVR | aortopathy bicuspid aortic valve

  https://www.uscjournal.com/articles/bicuspid-aortic-stenosis-and-without-aortopathy-considerations-surgical-aortic-valve?language_content_entity=en

  Decision-making in the management of patients with stenotic BAV is difficult and highlights the utility and strength of the heart team approach. […] Our understanding of the role of TAVR in BAV is evolving with ongoing clinical trials and our understanding of BAV and accompanying aortopathy is expanding as well. […] When considering the lifetime management of patients with aortic valve disease, both TAVR and SAVR need to be discussed by the heart team.

• #77 Bicuspid Aortic Valve: Symptoms & Treatment | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/bicuspid-aortic-valve

  Some people may benefit from medication, but if symptoms are severe, your doctor will usually recommend bicuspid aortic valve surgery, such as bicuspid aortic valve replacement or bicuspid aortic valve repair. […] Depending on the nature and severity of the disease, you may receive either minimally invasive or open-heart surgery. The average age of bicuspid aortic valve replacement is about 60 years old. With proper care, including valve surgery when necessary, the life expectancy of a person with a bicuspid aortic valve is the same as that of the general population. […] No, heart valves generally don’t heal on their own. While many people don’t experience symptoms for much of their lives, there’s no sure way to fix a bicuspid aortic valve except with surgery.

• #78 Bicuspid Aortic Valve Syndrome | Signs & Symptoms | Marfan Foundation

  https://marfan.org/conditions/bicuspid-aortic-valve/

  Bicuspid aortic valve is one of the most common congenital heart defects, appearing in 4.6 of every 1,000 live births. […] Bicuspid aortic valve can be diagnosed through medical testing, most often with an echocardiogram. […] Complications of bicuspid aortic valve include aortic aneurysm (bulge) and dissection (tear), which can be life-threatening, making it important for the condition to be diagnosed early and accurately. People who have been diagnosed with bicuspid aortic valve should be under the ongoing care of a heart valve disease specialist who can monitor changes in the heart, valves, and aorta over time. These changes may require surgery to replace the bicuspid valve and aortic aneurysm. […] Bicuspid aortic valve is highly heritable, and may be entirely determined by genetics. In large family studies, approximately 9 percent of first degree relatives of the person with a bicuspid aortic valve are found to also have a bicuspid aortic valve. This suggests an autosomal dominant inheritance (only need to get the altered gene from one parent) with a variable expression (range of features). However, the gene(s) that may cause this condition is currently unknown. […] Following your doctors recommendations for medication, monitoring, and physical activity gives you the best chance of avoiding a serious complication of a genetic aortic condition.

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