Applications of a specialty bicuspid aortic valve program: Clinical continuity and translational collaboration

Erin E. Crawford, Patrick M. McCarthy*, S. Chris Malaisrie, Jyothy J. Puthumana, Joshua D. Robinson, Michael Markl, Menghan Liu, Adin Cristian Andrei, David G. Guzzardi, Jane Kruse, Paul W.M. Fedak

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Bicuspid aortic valve (BAV) is a common congenital heart diagnosis and is associated with aortopathy. Current guidelines for aortic resection have been validated but are based on aortic diameter, which is insufficient to predict acute aortic events. Clinical and translational collaboration is necessary to identify biomarkers that can individualize the timing of prophylactic surgery for BAV aortopathy. We describe our multidisciplinary BAV program, including research protocols aimed at biomarker discovery and results from our longitudinal clinical registry. From 2012–2018, 887 patients enrolled in our clinical BAV registry with the option to undergo four dimensional flow cardiovascular magnetic resonance imaging (4D flow CMR) and donate serum plasma or tissue samples. Of 887 patients, 388 (44%) had an elective BAV-related procedure after initial presentation, while 499 (56%) continued with medical management. Of medical patients, 44 (9%) had elective surgery after 2.3 ± 1.4 years. Surgery patients’ biobank donations include 198 (46%) aorta, 374 (86%) aortic valve, and 314 (73%) plasma samples. The 4D flow CMR was completed for 215 (50%) surgery patients and 243 (49%) medical patients. Patients with BAV aortopathy can be safely followed by a multidisciplinary team to detect indications for surgery. Paired tissue and hemodynamic analysis holds opportunity for biomarker development in BAV aortopathy.

Original languageEnglish (US)
Article number1354
JournalJournal of Clinical Medicine
Volume9
Issue number5
DOIs
StatePublished - May 2020

Keywords

  • 4D MRI
  • Aortic aneurysm
  • Bicuspid aortic valve
  • Congenital heart disease

ASJC Scopus subject areas

  • Medicine(all)

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