Bicuspid aortic valve

Bicuspid aortic valve

Infobox_Disease
Name = Bicuspid aortic valve


Caption =
DiseasesDB = 1392
ICD10 =
ICD9 = ICD9|746.4
ICDO =
OMIM = 109730
MedlinePlus =
eMedicineSubj = ped
eMedicineTopic = 2486
MeshID =
A bicuspid aortic valve is a defect of the aortic valve that results in the formation of two leaflets or cusps instead of the normal three. Normally only the mitral valve has two cusps (instead of three); situated between the left atrium and left ventricle. Valves ensure the unidirectional flow of blood from the atrium to the ventricles, or the ventricles to the major arteries and veins.

Incidence/prevalence

About 1-2% of the population have bicuspid aortic valves, although the condition is nearly twice as common in males.

It is more common than any other congenital cardiac anomaly.cite journal |author=Tzemos N, Therrien J, Yip J, "et al" |title=Outcomes in adults with bicuspid aortic valves |journal=JAMA |volume=300 |issue=11 |pages=1317–25 |year=2008 |month=September |pmid=18799444 |doi=10.1001/jama.300.11.1317 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=18799444]

Bicuspid aortic valve has been found to be an inheritable condition, with a demonstrated association with Notch 1.cite journal |author=Garg V, Muth AN, Ransom JF, "et al" |title=Mutations in NOTCH1 cause aortic valve disease |journal=Nature |volume=437 |issue=7056 |pages=270–4 |year=2005 |pmid=16025100 |doi=10.1038/nature03940] Familial clustering as well as isolated valve defects have been documented. The incidence of bicuspid aortic valve can be as high as 10% in families affected with the valve problem. Other congential heart defects are associated with bicuspid aortic valve at various frequencies.

Presentation

In many cases, the condition will cause no problems. [cite web |url=http://www.americanheart.org/presenter.jhtml?identifier=991 |title=Ask the Pediatric Cardiologist - Bicuspid Aortic Valve |accessdate=2007-08-08 |format= |work=] However, especially in later life, a bicuspid aortic valve may become calcified, which may lead to varying degrees of severity of aortic stenosis and aortic regurgitation, which will manifest as murmurs. If these become severe enough, they may require heart surgery.

Diagnosis

The condition can be associated with a heart murmur located at the right 2nd intercostal space. Oftentimes there will be differences in blood pressures between upper and lower extremities. The diagnosis can be assisted with echocardiography and chest x-ray. "Rib notching" is often noted on chest x-ray.

Treatment/prognosis

Most patients with bicuspid aortic valve whose valve becomes dysfunctional will need careful follow-up and potentially valve replacement in their third or fourth decade of life.

Patients with bicuspid aortic valve should be followed by cardiologist or cardiac surgeon with specific interest in this valve pathology.

Average lifespan is similar to that of those without the anomaly.cite journal |author=Michelena HI, Desjardins VA, Avierinos JF, "et al" |title=Natural history of asymptomatic patients with normally functioning or minimally dysfunctional bicuspid aortic valve in the community |journal=Circulation |volume=117 |issue=21 |pages=2776–84 |year=2008 |month=May |pmid=18506017 |doi=10.1161/CIRCULATIONAHA.107.740878 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18506017]

Aorta

Another important fact is the aorta of patients with bicuspid aortic valve is not normal. The aorta of a patient with a bicuspid aortic valve does not have the same histological characteristics of a normal aorta. The tensile strength is reduced. These patients are at a higher risk for aortic dissection and aneurysm formation of the ascending aorta. The size of the proximal aorta should be evaluated carefully during the work-up. The initial diameter of the aorta should be noted and periodic evaluation with CT scan (every year or sooner if there is a change in aortic diameter) should be recommended. Therefore, if the patient needs surgery, the size of the aorta will determine what type of surgery should be offered to the patient. Additionally, patients with bicuspid aortic valve are at higher risk of aortic coarctation, an abnormal narrowing of the thoracic aorta.

References

External links

* [http://bicuspidfoundation.com/ Bicuspid Aortic Foundation Homepage]
* [http://www.csmc.edu/3893.html Cedars Sinai Heart Center - Bicuspid Aortic Disease]


Wikimedia Foundation. 2010.

Игры ⚽ Поможем решить контрольную работу

Look at other dictionaries:

  • Bicuspid aortic valve — Whereas the normal aortic valve in the heart has three flaps (cusps) that open and close, a bicupid valve has only two. There may be no symptoms in childhood, but in time the valve may become stenotic (narrowed), making it harder for blood to… …   Medical dictionary

  • Aortic valve stenosis — Classification and external resources ICD 10 I35.0, I06.0, Q23.0 …   Wikipedia

  • Aortic valve — The aortic valve is one of the valves of the heart. It lies between the left ventricle and the aorta.Function PhysiologyDuring ventricular systole, pressure rises in the left ventricle. When the pressure in the left ventricle rises above the… …   Wikipedia

  • Aortic valve, bicuspid — Whereas the normal aortic valve in the heart has three flaps (cusps) that open and close, a bicupid valve has only two. There may be no symptoms in childhood, but in time the valve may become stenotic (narrowed), making it harder for blood to… …   Medical dictionary

  • Aortic dissection — Classification and external resources Dissection of the aorta descendens (3), which starts from the left subclavian artery, reaching to the abdominal aorta (4). Aorta ascendens (1) and aortic arch (2) are not involved …   Wikipedia

  • Aortic insufficiency — See also: mitral regurgitation and tricuspid insufficiency Aortic insufficiency Classification and external resources Micrograph of myxomatous degeneration – a cause of aortic insufficiency …   Wikipedia

  • Bicuspid — Having two flaps or cusps. The heart valve that is called the bicuspid valve is located between the left atrium and left ventricle. Although the aortic valve in the heart normally is tricuspid (with three cusps), it may sometimes be bicupid. * *… …   Medical dictionary

  • Aortic stenosis — Narrowing (stenosis) of the heart valve between the left ventricle of the heart and the aorta. This narrowing impedes the delivery of blood through the aorta to the body and makes it tough for the heart to carry out this Herculean task. A normal… …   Medical dictionary

  • Heart valve — In anatomy, the heart valves are valves in the heart that maintain the unidirectional flow of blood by opening and closing depending on the difference in pressure on each side. The mechanical equivalent of the heart valves would be the reed… …   Wikipedia

  • Mitral valve — Anterior (frontal) view of the opened heart. White arrows indicate normal blood flow. (Mitral valve labeled at center right.) …   Wikipedia

Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”