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Cardiology Research and Practice
Volume 2012 (2012), Article ID 145202, 16 pages
http://dx.doi.org/10.1155/2012/145202
Review Article

Bicuspid Aortic Valve Disease and Ascending Aortic Aneurysms: Gaps in Knowledge

1Department of Anatomy & Cell Biology, University of Western Ontario, London, ON, Canada N6A 5C1
2Division of Cardiac Surgery, Department of Surgery, Lawson Health Research Institute, University of Western Ontario, London, ON, Canada N6A 5A5
3B6-106 University Hospital, London Health Sciences Centre, 339 Windermere Road, P.O. Box 5339, London, ON, Canada N6A 5A5

Received 28 February 2012; Accepted 7 August 2012

Academic Editor: Ani C. Anyanwu

Copyright © 2012 Katie L. Losenno et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The bicuspid aortic valve is the most common congenital cardiac anomaly in developed nations. The abnormal bicuspid morphology of the aortic valve results in valvular dysfunction and subsequent hemodynamic derangements. However, the clinical presentation of bicuspid aortic valve disease remains quite heterogeneous with patients presenting from infancy to late adulthood with variable degrees of valvular stenosis and insufficiency and associated abnormalities including aortic coarctation, hypoplastic left heart structures, and ascending aortic dilatation. Emerging evidence suggests that the heterogeneous presentation of bicuspid aortic valve phenotypes may be a more complex matter related to congenital, genetic, and/or connective tissue abnormalities. Optimal management of patients with BAV disease and associated ascending aortic aneurysms often requires a thoughtful approach, carefully assessing various risk factors of the aortic valve and the aorta and discerning individual indications for ongoing surveillance, medical management, and operative intervention. We review current concepts of anatomic classification, pathophysiology, natural history, and clinical management of bicuspid aortic valve disease with associated ascending aortic aneurysms.