Intima-media thickness of the descending aorta in patients with bicuspid aortic valve

Background: Bicuspid aortic valve is the most frequent congenital cardiac abnormality and associated with proximal aortic disease (i.e. aneurysm, dissection or rupture). Granular media calcinosis(GMC)--suggested to increase stiffness and play a pathogenetic role in dissecting aneurysm--has not yet been quantified in BAV. Methods: Specimen of the proximal aortic wall from 76 patients--32 with tricuspid (TAV) and 44 with bicuspid aortic valve (BAV)--were obtained during surgery to quantify media thickness and GMC by von Kossa staining (panel C), comparing the convexity (Cvx) and concavity (Ccv) in BAV vs. TAV. Results: Interlamellar GMC affected the most central layers of the media and those adjacent to the outer adventitia with a doubling within both--the Cvx and Ccv--of pts with BAV compared to patients with TAV (13.3±9.6 vs. 6.6±7.4 and 12.8±10.8 vs. 6.4±7.1; p<0.05, panel A) was seen, but neither a difference in calcification between the Ccx and the Ccv side within the BAV nor the TAV group. No association between age and calcification grade , neither in the Cvx nor the Ccv (r=0.132, p=0.218 and 0.103, p=0.341) was seen. There was a significant difference in the total media thickness between BAV and TAV at the Cvx (867±162μm vs . 993±158μm; p<0.05) and the Ccv (1005 ± 236 vs 1223 ± 217μm; p<0.05, panel B). Independent of aortic valve morphology, the Cvx was thinner than the Ccv side (TAV: 993 ± 158 vs.1223 ± 217μm; p<0.001; BAV: 869 ± 162 vs.1005 ± 236μm; p<0.05, panel B). Conclusion: BAVs had significantly thinner media and twice as much GMC than their tricuspid peers possibly associated with the loosening of the bond between the elastic lamellae causing a decrease in elasticity possibly explaining a higher risk for dissection and rupture.

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WO8-OR-6 CAROTID INTIMA-MEDIA THICKNESS, CAROTID DISTENSIBILITY AND MITRAL, AORTIC VALVE CALCIFICATION: A USEFUL DIAGNOSTIC PARAMETER OF SYSTEMIC ATHEROSCLEROTIC DISEASE

Atherosclerosis Supplements ◽

10.1016/s1567-5688(07)70978-9 ◽

2007 ◽

Vol 8 (1) ◽

pp. 9

Author(s):

L. Sgorbini ◽

G. Di Donato

Keyword(s):

Aortic Valve ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Atherosclerotic Disease ◽

Diagnostic Parameter ◽

Aortic Valve Calcification ◽

Valve Calcification ◽

Media Thickness ◽

Carotid Distensibility

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A rarely seen fistula between coronary artery-descending aorta in a patient with coarctation of aorta and bicuspid aortic valve stenosis

Journal of Cardiology Cases ◽

10.1016/j.jccase.2012.06.011 ◽

2012 ◽

Vol 6 (4) ◽

pp. e103-e105

Author(s):

Ender Emre ◽

Tayfun Sahin ◽

Umut Celikyurt ◽

H. Tahsin Sarisoy ◽

Sadan Yavuz ◽

...

Keyword(s):

Coronary Artery ◽

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Aortic Valve Stenosis ◽

Coarctation Of Aorta ◽

Descending Aorta

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908 Evaluation of carotid intima-media thickness in patients with aortic valve calcifications

European Journal of Echocardiography ◽

10.1016/s1525-2167(03)91029-8 ◽

2003 ◽

Vol 4 ◽

pp. S118

Author(s):

A KABLAKZIEMBICKA ◽

T PRZEWLOCKI ◽

A MURA ◽

P PODOLEC ◽

M PASOWICZ ◽

...

Keyword(s):

Aortic Valve ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Media Thickness

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An incidental finding of a bicuspid aortic valve and pseudocoarctation of the descending aorta in a patient presenting with an acute coronary syndrome: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa105 ◽

2020 ◽

Vol 4 (3) ◽

pp. 1-5

Author(s):

Hari Vivekanantham ◽

Stéphane Cook ◽

Jean-Christophe Stauffer

Keyword(s):

Acute Coronary Syndrome ◽

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Incidental Finding ◽

Acute Chest Pain ◽

Low Grade ◽

Descending Aorta ◽

Coronary Syndrome ◽

Congenital Cardiac Anomalies ◽

Work Up

Abstract Background Aortic pseudocoarctation (PsCoA) is an elongation of the supra-isthmic aorta with kinking and low-grade narrowing. Consequently, no collateral circulation is found. It is frequently associated with other congenital heart anomalies, such as bicuspid aortic valve (BAV). Case summary We report the case of 60-year-old patient who presented to the ED with acute chest pain. Physical examination was remarkable for an elevated blood pressure (BP) and the presence of a systolic murmur on the left lower sternal border. An acute coronary syndrome was suspected and the patient underwent urgent coronary angiogram which showed an occluded obtuse marginal artery. Additionally, the presence of an aortic anomaly was noted during the aortography, and additional work-up, including a thoracic computed tomography angiography and transoesophageal echocardiography, revealed a BAV and a PsCoA of the descending aorta. The patient was discharged after optimizing BP control with oral medication and periodical follow-up was arranged. Discussion Aortic PsCoA may mimic true coarctation (CoA), but the absence of a haemodynamically significant descending aortic narrowing and of the typical clinical findings associated with aortic CoA, distinguishes both entities. Treatment is therefore conservative and based on the control of cardiovascular risk factors and in particular of arterial hypertension. Work-up should include imaging of the entire aorta and the search for associated congenital cardiac anomalies, which, if present, should be managed in consequence.

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The analysis of ascending aortic dilatation in patients with a bicuspid aortic valve using the ratio of the diameters of the ascending and descending aorta

Journal of Cardiothoracic Surgery ◽

10.1186/1749-8090-9-108 ◽

2014 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Yuki Nakamura ◽

Masahiro Ryugo ◽

Fumiaki Shikata ◽

Masahiro Okura ◽

Toru Okamura ◽

...

Keyword(s):

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Aortic Dilatation ◽

Descending Aorta

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Serial evaluation of the thoracic aorta in patients with a bicuspid aortic valve: A magnetic resonance angiography study

VASA ◽

10.1024/0301-1526/a000019 ◽

2010 ◽

Vol 39 (2) ◽

pp. 140-144 ◽

Cited By ~ 1

Author(s):

Tutarel ◽

Meyer ◽

Lotz ◽

Westhoff-Bleck

Keyword(s):

Aortic Valve ◽

Thoracic Aorta ◽

Bicuspid Aortic Valve ◽

Aortic Root ◽

Innominate Artery ◽

Ascending Aorta ◽

Current Data ◽

Descending Aorta ◽

Valve Function ◽

A Prospective Study

Background: Bicuspid aortic valve (BAV) is associated with an arteriopathy leading to a progressive dilatation of the aortic root. Recent studies have shown that the whole thoracic aorta is affected by this arteriopathy. Longitudinal data regarding the progression of this arteriopathy in the whole thoracic aorta has not been reported before. Patients and methods: In this retrospective study 40 patients (mean age 28.5 ± 9.1 years) had 2 MR-angiographies (mean interval 37.1 ± 15.2 months). In 23 patients the aortic valve was regurgitant, in 1 stenotic, in 4 combined aortic stenosis / regurgitation was found, while in 12 the valve function was normal. Aortic diameters were measured at 6 different, standardized anatomical points. The influence of demographic and clinical parameters was assessed. Results: A significant increase of the diameter was observed at the aortic root (35.4 ± 5.6 mm → 39.1 ± 6.5 mm, p < 0.001), the ascending aorta (37.3 ± 8.0 mm → 39.5 ± 8.5 mm, p = 0.001), proximal to the innominate artery (29.4 ± 6.1 mm → 31.6 ± 6.8 mm, p = 0.008), and the descending aorta (20.2 ± 2.4 mm → 21.6 ± 4.2 mm, p = 0.03). There was no significant increase proximal (24.0 ± 5.7 mm → 24.6 ± 5.3 mm, p = 0.44) and distal to the left subclavian artery (21.4 ± 4.6 mm → 21.9 ± 4.5 mm, p = 0.19). These observations were independent of the presence of arterial hypertension, a previous operation, gender, and functional status of the aortic valve. Conclusions: The progressive dilatation of the aortic root and ascending aorta that can be observed in patients with BAV was not found in the more distal parts of the thoracic aorta with the exception of the descending aorta in this study. If the dilatation of the descending aorta bears any clinical significance can't be answered with the current data. A prospective study should be performed to confirm these results.

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