Evolution of precision medicine and surgical strategies for bicuspid aortic valve-associated aortopathy

Ali Fatehi Hassanabad, Alex J Barker, David Guzzardi, Michael Markl, S Chris Malaisrie, Patrick M McCarthy, Paul W.M. Fedak*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish (US)
Article number475
JournalFrontiers in Physiology
Volume8
Issue numberJUL
DOIs
StatePublished - Jul 10 2017

Fingerprint

Precision Medicine
Mitral Valve
Aorta
Aortic Rupture
Aortic Diseases
Translational Medical Research
Aortic Valve
Dissection
Dilatation
Patient Care
Biomarkers
Hemodynamics
Guidelines
Bicuspid Aortic Valve
Growth

Keywords

  • Aortopathy
  • Bicuspid aortic valve
  • Biomarkers discovery
  • MRI
  • Precision medicine

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

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title = "Evolution of precision medicine and surgical strategies for bicuspid aortic valve-associated aortopathy",
abstract = "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.",
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Evolution of precision medicine and surgical strategies for bicuspid aortic valve-associated aortopathy. / Hassanabad, Ali Fatehi; Barker, Alex J; Guzzardi, David; Markl, Michael; Malaisrie, S Chris; McCarthy, Patrick M; Fedak, Paul W.M.

In: Frontiers in Physiology, Vol. 8, No. JUL, 475, 10.07.2017.

Research output: Contribution to journalArticle

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AU - McCarthy, Patrick M

AU - Fedak, Paul W.M.

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