Bicuspid Aortic Valves Are Associated With Increased Turbulence Compared to Pure Aortic Stenosis: An In Vitro Study

In about 1–2% of all live births, the human aortic valve only consists of two anomalous leaflets and is known as the bicuspid aortic valve (BAV). BAVs are the most common congenital cardiac anomaly, and are associated with significant valvular dysfunction, including calcific aortic stenosis (AS) and aortic regurgitation (AR), as well as aortic wall abnormalities including coarctation of the aorta, ascending aortic dilatation and aneurysms [1]. Many studies have proposed a common underlying genetic defect in progression of complications with BAVs [2]. However, other recent studies have also suggested that the altered hemodynamic environment associated with BAVs could also be responsible for accelerated disease progression in these patients [3, 4]. A recent in vitro study showed elevated levels of turbulence associated with BAVs, and indicated that fluid flow patterns in the aortic sinuses are also affected due to the altered valve morphology [5]. The present work seeks to compare the levels of turbulence in BAVs to pure trileaflet aortic stenosis models.