scholarly journals Aortic Stenosis and Regurgitation with Aortic Subannular Left Ventricular Diverticulum and Occlusion of the Right Coronary Ostium by the Bicuspid Aortic Valve

2019 ◽  
Vol 48 (4) ◽  
pp. 234-238
Author(s):  
Iwao Hioki ◽  
Yasuhisa Urata ◽  
Tomoaki Sato ◽  
Uhito Yuasa
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Bicuspid Aortic Valve ◽  
Left Ventricular ◽  
Coronary Ostium ◽  
Ventricular Diverticulum ◽  
Left Ventricular Diverticulum ◽  
The Right

Left ventricular outflow tract obstruction (LVOTO)

2011 ◽  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Bicuspid Aortic Valve ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow ◽  
Different Levels

Introduction 68Subvalvar aortic stenosis (AS) 70Bicuspid aortic valve 72Supravalvar AS 74LVOTO may occur at different levels: • Subvalvular.• Valvular—including bicuspid aortic valve.• Supravalvular.• Coarctation— see p.118.Effects of LVOTO, irrespective of site of lesion, are: • ↑ afterload on LV....

scholarly journals Right Ventricular Outflow Tract Tachycardia with Structural Abnormalities of the Right Ventricle and Left Ventricular Diverticulum

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Bortolo Martini ◽  
Nicola Trevisi ◽  
Nicolò Martini ◽  
Li Zhang
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Diverticulum ◽  
Right Ventricular Wall ◽  
Left Ventricular Diverticulum ◽  
The Right

A 43-year-old woman presented to the emergency room with a sustained ventricular tachycardia (VT). ECG showed a QRS in left bundle branch block morphology with inferior axis. Echocardiography, ventricular angiography, and cardiac magnetic resonance imaging (CMRI) revealed a normal right ventricle and a left ventricular diverticulum. Electrophysiology studies with epicardial voltage mapping identified a large fibrotic area in the inferolateral layer of the right ventricular wall and a small area of fibrotic tissue at the anterior right ventricular outflow tract. VT ablation was successfully performed with combined epicardial and endocardial approaches.

scholarly journals Causal Relationship of Transverse Left Ventricular Band and Bicuspid Aortic Valve

2021 ◽  
Author(s):  
Manoj Kumar Dubey ◽  
Avinash Mani ◽  
Vineeta Ojha
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Bicuspid Aortic Valve ◽  
Surrogate Marker ◽  
Left Ventricular ◽  
The Other ◽  
Average Thickness ◽  
Transverse Band ◽  
Study Population ◽  
Relationship Of

Objectives: Bicuspid aortic valve is the most common congenital lesion found in adults. It is can be seen in combination with a transverse left ventricular (LV) band. We aimed to find an essential relationship between the presence of transverse ventricular band and bicuspid aortic valve. Methods: 13 patients with transverse left ventricular band were investigated during a 6 month period from January 2019 to July 2019. LV band thickness and gradients at the site of the LV band were evaluated as part of its effect on LV hemodynamics. Morphology of aortic valve and LV outflow tract gradients were assessed. We aimed to establish the presence of robust LV band as a surrogate marker for bicuspid aortic valve and evaluate the effect of LV band on LV hemodynamics. Results: Mean age of study population was 41yrs. Majority had bicuspid aortic valve(n=11). Average thickness of transverse band was 6.2mm and average mean aortic gradient was4mmHg. Sequestration of blood was noted at the level of transverse band in all the patients with 2 separate jets at LVOT. Anterolateral jet was deflected from transverse band and showed higher velocity in comparison to the other jet, causing turbulence at the bicuspid aortic valve. No co-relation was found between the thickness of transverse band and aortic valve gradient. Conclusion: Presence of a robust transverse LV band can serve as a surrogate marker for bicuspid aortic valve. Keywords: Bicuspid aortic valve ; aortic stenosis

Surgical Experience with Doty's Repair for Supravalvular Aortic Stenosis

1996 ◽  
Vol 4 (1) ◽  
pp. 29-32
Author(s):  
Balram Airan ◽  
Sunil K Kaushal ◽  
Anil Bhan ◽  
Panangipalli Venugopal
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Coronary Sinus ◽  
Innominate Artery ◽  
Left Ventricular ◽  
Supravalvular Aortic Stenosis ◽  
Coarctation Of Aorta ◽  
Valve Function ◽  
Aortic Obstruction ◽  
The Right

The surgical treatment of severe supravalvular aortic stenosis by conventional, asymmetrical, one point patch aortoplasty across the narrowed area has been associated with a substantial incidence of residual stenosis and reoperations. Almost symmetrical relief of such stenosis was achieved with Doty's extended aortoplasty in 5 patients in whom left ventricular aortic gradient was reduced from 60–170 nun Hg to 0–25 mm Hg. This technique of inserting an inverted V-shaped gusset across the stenosed segment into the right coronary sinus and non-coronary sinus, restores the aortic root geometry, provides more predictable relief of aortic obstruction and also improves aortic valve function. Associated procedures involved relief of coarctation of aorta and innominate artery stenosis in 1 case and repair of aortic valve and mitral valve in another case.

Genetic and Developmental Contributors to Aortic Stenosis

2021 ◽  
Vol 128 (9) ◽  
pp. 1330-1343 ◽  
Author(s):  
Punashi Dutta ◽  
Jeanne F. James ◽  
Hail Kazik ◽  
Joy Lincoln
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Bicuspid Aortic Valve ◽  
Financial Burden ◽  
Left Ventricular ◽  
Valve Disease ◽  
Outflow Obstruction ◽  
Left Ventricular Outflow Obstruction ◽  
Ventricular Outflow Obstruction ◽  
Left Ventricular Outflow

Aortic stenosis (AS) remains one of the most common forms of valve disease, with significant impact on patient survival. The disease is characterized by left ventricular outflow obstruction and encompasses a series of stenotic lesions starting from the left ventricular outflow tract to the descending aorta. Obstructions may be subvalvar, valvar, or supravalvar and can be present at birth (congenital) or acquired later in life. Bicuspid aortic valve, whereby the aortic valve forms with two instead of three cusps, is the most common cause of AS in younger patients due to primary anatomic narrowing of the valve. In addition, the secondary onset of premature calcification, likely induced by altered hemodynamics, further obstructs left ventricular outflow in bicuspid aortic valve patients. In adults, degenerative AS involves progressive calcification of an anatomically normal, tricuspid aortic valve and is attributed to lifelong exposure to multifactoral risk factors and physiological wear-and-tear that negatively impacts valve structure-function relationships. AS continues to be the most frequent valvular disease that requires intervention, and aortic valve replacement is the standard treatment for patients with severe or symptomatic AS. While the positive impacts of surgical interventions are well documented, the financial burden, the potential need for repeated procedures, and operative risks are substantial. In addition, the clinical management of asymptomatic patients remains controversial. Therefore, there is a critical need to develop alternative approaches to prevent the progression of left ventricular outflow obstruction, especially in valvar lesions. This review summarizes our current understandings of AS cause; beginning with developmental origins of congenital valve disease, and leading into the multifactorial nature of AS in the adult population.

Left ventricular outflow tract obstruction

2016 ◽  
Author(s):  
Demosthenes G. Katritsis ◽  
Bernard J. Gersh ◽  
A. John Camm
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Bicuspid Aortic Valve ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow ◽  
Valvular Aortic Stenosis

Conditions that result in left ventricular outflow tract obstruction, i.e. valvular aortic stenosis, due to a bicuspid aortic valve, and subvalvular and supravalvular aortic stenosis are discussed.

Abstract 14914: Advanced 4D-flow Measurements of Aortic Forward Flow, Reverse Flow, and Stasis in Bicuspid Aortic Valve Patients Without Aortic Stenosis or Regurgitation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Patrick Geeraert ◽  
Fatemehsadat jamalidinan ◽  
Ali Fatehi Hassanabad ◽  
James White ◽  
Julio Garcia Flores
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Bicuspid Aortic Valve ◽  
Cardiac Cycle ◽  
Reverse Flow ◽  
Left Ventricular ◽  
Healthy Controls ◽  
4D Flow ◽  
Descending Aorta ◽  
Forward Flow

Introduction: Precise analysis of aortic hemodynamics is crucial in the study of bicuspid aortic valve (BAV) disease. This study provides a comprehensive evaluation of aortic forward flow (FF), reverse flow (RF) and stasis in BAV patients using novel 3D-based techniques previously shown to be more accurate than traditional 2D analysis methods. Hypothesis: BAV patients without valve dysfunction show abnormal aortic FF, RF, and stasis compared to healthy controls. Methods: We recruited 44 BAV patients (48±15 yrs, 27% female) and 23 healthy controls (37±14 yrs, 35% female). Cardiac MRI at 3T was performed inclusive of 4D-flow imaging. Patients with any aortic stenosis (AS) or ≥mild regurgitation (AR) were excluded. Flow analysis was performed by segmented volumetric regions: left ventricular outflow tract (LVOT), ascending aorta (AAo), arch, proximal descending aorta (PDAo), and distal descending aorta (DDAo). In each region, forward flow (FF), reverse flow (RF) and stasis were averaged over the cardiac cycle on a voxel-by-voxel basis. Left ventricular (LV) end-diastolic volume, end-systolic volume and ejection fraction were also measured. T-tests (or non-parametric equivalent) compared differences in parameters between cohorts. Results: BAV patients were significantly older than controls (48±15 vs. 37±14 yrs; p=0.01) but exhibited no significant differences in LV measures. Patients showed reduced FF in the AAo (0.09±0.03 vs. 0.11±0.04 mL/cycle; p<0.01), but greater FF in all downstream regions (eg. PDA: 0.02±0.03 vs. 0.01±0.02 mL/cycle; p=0.01). RF was significantly elevated in patients in the AAo (0.06±0.02 vs. 0.02±0.02 mL/cycle; p<0.01). BAV patients exhibited significantly less stasis in every region except the DDAo (eg. AAo: 23±11 vs. 50±10 % of cardiac cycle). Conclusions: 3D-derived measurements of FF, RF, and stasis are significantly altered in the thoracic aorta of BAV patients in the absence of AS or AR.

scholarly journals Rheumatic Bicuspid Aortic Valve Causing Device Embolization during Transcatheter Aortic Valve Replacement

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Uoo Kim
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Bicuspid Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
Transcatheter Aortic Valve ◽  
Device Embolization

Transcatheter aortic valve replacement (TAVR) has emerged as a feasible alternative for treatment of severe aortic stenosis with comparable outcomes to surgical aortic valve replacement (SAVR) in recent years. We present a case of device embolization in the left ventricular outflow tract (LVOT) during TAVR in a patient with severe aortic stenosis that required emergent surgical intervention. During the open-heart surgery for embolized prosthesis extraction and SAVR, both TEE exam and surgical specimen demonstrated bicuspid aortic valve and rheumatic nature of the valve with lack of calcification, which were identified to be the two main factors that contributed to the complication. In which the insufficient annular calcification increases the risk of device embolization due to lack of an adequate landing zone for device anchoring, and the anatomy of bicuspid valve contributes to the complication due to its associated large annular size and horizontal aorta. This case highlights device embolization as one possible complication of TAVR which is associated with substantial morbidity and mortality, the clinical management process was thoroughly documented with aortic angiography and transoesophageal echocardiography imaging.

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