Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making

Opinion statement The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection. Because the understanding of the complexity of the BAV phenotype is evolving as quickly as are the options for medical, surgical, and interventional therapy, this review aims to provide an update on the most clinically relevant recent advances in the realm of BAV and associated aortopathy from a genetic, morphologic, and clinical outcomes perspective in order to give the practicing clinician a deeper understanding of how to approach both medical and surgical decision-making in the patient with BAV. The following major principles have emerged in recent years including (1) the importance of cusp anatomy and its implications on the long-term risk of AI, aortic dilation, and aortic dissection, (2) the role of post-valvular flow dynamics in the pathogenesis of aortic dilation in BAV patients, (3) the ability of aortic valve replacement to halt accelerated dilation rates, and (4) the finding that the risk of aortic dissection, while still overall intermediate is much more akin to the baseline risk present in TAV patients rather than the much higher rates observed in patients with Marfan’s disease. Together, these data support the less aggressive approach to aortic replacement in BAV patients as reflected in the most recent ACC/AHA guidelines and provide a stronger basis upon which future studies, including those aimed at medical and transcatheter therapies, stand to make further impact on our ability to optimally treat this epidemiologically important and complex population of patients. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Kwon, Michael H. [verfasserIn] Sundt, Thoralf M. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2017

Schlagwörter:	Bicuspid aortic valve Aortic insufficiency Aortic stenosis Tricuspid aortic valves

Übergeordnetes Werk:	Enthalten in: Current treatment options in cardiovascular medicine - Philadelphia, Pa. : Current Science Inc., 1999, 19(2017), 9 vom: 05. Aug.
Übergeordnetes Werk:	volume:19 ; year:2017 ; number:9 ; day:05 ; month:08

Links:	Volltext

DOI / URN:	10.1007/s11936-017-0569-8

Katalog-ID:	SPR023063386

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allfields	10.1007/s11936-017-0569-8 doi (DE-627)SPR023063386 (SPR)s11936-017-0569-8-e DE-627 ger DE-627 rakwb eng 610 ASE 44.85 bkl Kwon, Michael H. verfasserin aut Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Opinion statement The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection. Because the understanding of the complexity of the BAV phenotype is evolving as quickly as are the options for medical, surgical, and interventional therapy, this review aims to provide an update on the most clinically relevant recent advances in the realm of BAV and associated aortopathy from a genetic, morphologic, and clinical outcomes perspective in order to give the practicing clinician a deeper understanding of how to approach both medical and surgical decision-making in the patient with BAV. The following major principles have emerged in recent years including (1) the importance of cusp anatomy and its implications on the long-term risk of AI, aortic dilation, and aortic dissection, (2) the role of post-valvular flow dynamics in the pathogenesis of aortic dilation in BAV patients, (3) the ability of aortic valve replacement to halt accelerated dilation rates, and (4) the finding that the risk of aortic dissection, while still overall intermediate is much more akin to the baseline risk present in TAV patients rather than the much higher rates observed in patients with Marfan’s disease. Together, these data support the less aggressive approach to aortic replacement in BAV patients as reflected in the most recent ACC/AHA guidelines and provide a stronger basis upon which future studies, including those aimed at medical and transcatheter therapies, stand to make further impact on our ability to optimally treat this epidemiologically important and complex population of patients. Bicuspid aortic valve (dpeaa)DE-He213 Aortic insufficiency (dpeaa)DE-He213 Aortic stenosis (dpeaa)DE-He213 Tricuspid aortic valves (dpeaa)DE-He213 Sundt, Thoralf M. verfasserin aut Enthalten in Current treatment options in cardiovascular medicine Philadelphia, Pa. : Current Science Inc., 1999 19(2017), 9 vom: 05. Aug. (DE-627)355400073 (DE-600)2090727-8 1534-3189 nnns volume:19 year:2017 number:9 day:05 month:08 https://dx.doi.org/10.1007/s11936-017-0569-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.85 ASE AR 19 2017 9 05 08
spelling	10.1007/s11936-017-0569-8 doi (DE-627)SPR023063386 (SPR)s11936-017-0569-8-e DE-627 ger DE-627 rakwb eng 610 ASE 44.85 bkl Kwon, Michael H. verfasserin aut Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Opinion statement The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection. Because the understanding of the complexity of the BAV phenotype is evolving as quickly as are the options for medical, surgical, and interventional therapy, this review aims to provide an update on the most clinically relevant recent advances in the realm of BAV and associated aortopathy from a genetic, morphologic, and clinical outcomes perspective in order to give the practicing clinician a deeper understanding of how to approach both medical and surgical decision-making in the patient with BAV. The following major principles have emerged in recent years including (1) the importance of cusp anatomy and its implications on the long-term risk of AI, aortic dilation, and aortic dissection, (2) the role of post-valvular flow dynamics in the pathogenesis of aortic dilation in BAV patients, (3) the ability of aortic valve replacement to halt accelerated dilation rates, and (4) the finding that the risk of aortic dissection, while still overall intermediate is much more akin to the baseline risk present in TAV patients rather than the much higher rates observed in patients with Marfan’s disease. Together, these data support the less aggressive approach to aortic replacement in BAV patients as reflected in the most recent ACC/AHA guidelines and provide a stronger basis upon which future studies, including those aimed at medical and transcatheter therapies, stand to make further impact on our ability to optimally treat this epidemiologically important and complex population of patients. Bicuspid aortic valve (dpeaa)DE-He213 Aortic insufficiency (dpeaa)DE-He213 Aortic stenosis (dpeaa)DE-He213 Tricuspid aortic valves (dpeaa)DE-He213 Sundt, Thoralf M. verfasserin aut Enthalten in Current treatment options in cardiovascular medicine Philadelphia, Pa. : Current Science Inc., 1999 19(2017), 9 vom: 05. Aug. (DE-627)355400073 (DE-600)2090727-8 1534-3189 nnns volume:19 year:2017 number:9 day:05 month:08 https://dx.doi.org/10.1007/s11936-017-0569-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.85 ASE AR 19 2017 9 05 08
allfields_unstemmed	10.1007/s11936-017-0569-8 doi (DE-627)SPR023063386 (SPR)s11936-017-0569-8-e DE-627 ger DE-627 rakwb eng 610 ASE 44.85 bkl Kwon, Michael H. verfasserin aut Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Opinion statement The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection. Because the understanding of the complexity of the BAV phenotype is evolving as quickly as are the options for medical, surgical, and interventional therapy, this review aims to provide an update on the most clinically relevant recent advances in the realm of BAV and associated aortopathy from a genetic, morphologic, and clinical outcomes perspective in order to give the practicing clinician a deeper understanding of how to approach both medical and surgical decision-making in the patient with BAV. The following major principles have emerged in recent years including (1) the importance of cusp anatomy and its implications on the long-term risk of AI, aortic dilation, and aortic dissection, (2) the role of post-valvular flow dynamics in the pathogenesis of aortic dilation in BAV patients, (3) the ability of aortic valve replacement to halt accelerated dilation rates, and (4) the finding that the risk of aortic dissection, while still overall intermediate is much more akin to the baseline risk present in TAV patients rather than the much higher rates observed in patients with Marfan’s disease. Together, these data support the less aggressive approach to aortic replacement in BAV patients as reflected in the most recent ACC/AHA guidelines and provide a stronger basis upon which future studies, including those aimed at medical and transcatheter therapies, stand to make further impact on our ability to optimally treat this epidemiologically important and complex population of patients. Bicuspid aortic valve (dpeaa)DE-He213 Aortic insufficiency (dpeaa)DE-He213 Aortic stenosis (dpeaa)DE-He213 Tricuspid aortic valves (dpeaa)DE-He213 Sundt, Thoralf M. verfasserin aut Enthalten in Current treatment options in cardiovascular medicine Philadelphia, Pa. : Current Science Inc., 1999 19(2017), 9 vom: 05. Aug. (DE-627)355400073 (DE-600)2090727-8 1534-3189 nnns volume:19 year:2017 number:9 day:05 month:08 https://dx.doi.org/10.1007/s11936-017-0569-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.85 ASE AR 19 2017 9 05 08
allfieldsGer	10.1007/s11936-017-0569-8 doi (DE-627)SPR023063386 (SPR)s11936-017-0569-8-e DE-627 ger DE-627 rakwb eng 610 ASE 44.85 bkl Kwon, Michael H. verfasserin aut Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Opinion statement The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection. Because the understanding of the complexity of the BAV phenotype is evolving as quickly as are the options for medical, surgical, and interventional therapy, this review aims to provide an update on the most clinically relevant recent advances in the realm of BAV and associated aortopathy from a genetic, morphologic, and clinical outcomes perspective in order to give the practicing clinician a deeper understanding of how to approach both medical and surgical decision-making in the patient with BAV. The following major principles have emerged in recent years including (1) the importance of cusp anatomy and its implications on the long-term risk of AI, aortic dilation, and aortic dissection, (2) the role of post-valvular flow dynamics in the pathogenesis of aortic dilation in BAV patients, (3) the ability of aortic valve replacement to halt accelerated dilation rates, and (4) the finding that the risk of aortic dissection, while still overall intermediate is much more akin to the baseline risk present in TAV patients rather than the much higher rates observed in patients with Marfan’s disease. Together, these data support the less aggressive approach to aortic replacement in BAV patients as reflected in the most recent ACC/AHA guidelines and provide a stronger basis upon which future studies, including those aimed at medical and transcatheter therapies, stand to make further impact on our ability to optimally treat this epidemiologically important and complex population of patients. Bicuspid aortic valve (dpeaa)DE-He213 Aortic insufficiency (dpeaa)DE-He213 Aortic stenosis (dpeaa)DE-He213 Tricuspid aortic valves (dpeaa)DE-He213 Sundt, Thoralf M. verfasserin aut Enthalten in Current treatment options in cardiovascular medicine Philadelphia, Pa. : Current Science Inc., 1999 19(2017), 9 vom: 05. Aug. (DE-627)355400073 (DE-600)2090727-8 1534-3189 nnns volume:19 year:2017 number:9 day:05 month:08 https://dx.doi.org/10.1007/s11936-017-0569-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.85 ASE AR 19 2017 9 05 08
allfieldsSound	10.1007/s11936-017-0569-8 doi (DE-627)SPR023063386 (SPR)s11936-017-0569-8-e DE-627 ger DE-627 rakwb eng 610 ASE 44.85 bkl Kwon, Michael H. verfasserin aut Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Opinion statement The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection. Because the understanding of the complexity of the BAV phenotype is evolving as quickly as are the options for medical, surgical, and interventional therapy, this review aims to provide an update on the most clinically relevant recent advances in the realm of BAV and associated aortopathy from a genetic, morphologic, and clinical outcomes perspective in order to give the practicing clinician a deeper understanding of how to approach both medical and surgical decision-making in the patient with BAV. The following major principles have emerged in recent years including (1) the importance of cusp anatomy and its implications on the long-term risk of AI, aortic dilation, and aortic dissection, (2) the role of post-valvular flow dynamics in the pathogenesis of aortic dilation in BAV patients, (3) the ability of aortic valve replacement to halt accelerated dilation rates, and (4) the finding that the risk of aortic dissection, while still overall intermediate is much more akin to the baseline risk present in TAV patients rather than the much higher rates observed in patients with Marfan’s disease. Together, these data support the less aggressive approach to aortic replacement in BAV patients as reflected in the most recent ACC/AHA guidelines and provide a stronger basis upon which future studies, including those aimed at medical and transcatheter therapies, stand to make further impact on our ability to optimally treat this epidemiologically important and complex population of patients. Bicuspid aortic valve (dpeaa)DE-He213 Aortic insufficiency (dpeaa)DE-He213 Aortic stenosis (dpeaa)DE-He213 Tricuspid aortic valves (dpeaa)DE-He213 Sundt, Thoralf M. verfasserin aut Enthalten in Current treatment options in cardiovascular medicine Philadelphia, Pa. : Current Science Inc., 1999 19(2017), 9 vom: 05. Aug. (DE-627)355400073 (DE-600)2090727-8 1534-3189 nnns volume:19 year:2017 number:9 day:05 month:08 https://dx.doi.org/10.1007/s11936-017-0569-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.85 ASE AR 19 2017 9 05 08
language	English
source	Enthalten in Current treatment options in cardiovascular medicine 19(2017), 9 vom: 05. Aug. volume:19 year:2017 number:9 day:05 month:08
sourceStr	Enthalten in Current treatment options in cardiovascular medicine 19(2017), 9 vom: 05. Aug. volume:19 year:2017 number:9 day:05 month:08
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Bicuspid aortic valve Aortic insufficiency Aortic stenosis Tricuspid aortic valves
dewey-raw	610
isfreeaccess_bool	false
container_title	Current treatment options in cardiovascular medicine
authorswithroles_txt_mv	Kwon, Michael H. @@aut@@ Sundt, Thoralf M. @@aut@@
publishDateDaySort_date	2017-08-05T00:00:00Z
hierarchy_top_id	355400073
dewey-sort	3610
id	SPR023063386
language_de	englisch
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author	Kwon, Michael H.
spellingShingle	Kwon, Michael H. ddc 610 bkl 44.85 misc Bicuspid aortic valve misc Aortic insufficiency misc Aortic stenosis misc Tricuspid aortic valves Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making
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topic_title	610 ASE 44.85 bkl Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making Bicuspid aortic valve (dpeaa)DE-He213 Aortic insufficiency (dpeaa)DE-He213 Aortic stenosis (dpeaa)DE-He213 Tricuspid aortic valves (dpeaa)DE-He213
topic	ddc 610 bkl 44.85 misc Bicuspid aortic valve misc Aortic insufficiency misc Aortic stenosis misc Tricuspid aortic valves
topic_unstemmed	ddc 610 bkl 44.85 misc Bicuspid aortic valve misc Aortic insufficiency misc Aortic stenosis misc Tricuspid aortic valves
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title	Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making
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title_full	Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making
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title_sort	bicuspid aortic valvulopathy and associated aortopathy: a review of contemporary studies relevant to clinical decision-making
title_auth	Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making
abstract	Opinion statement The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection. Because the understanding of the complexity of the BAV phenotype is evolving as quickly as are the options for medical, surgical, and interventional therapy, this review aims to provide an update on the most clinically relevant recent advances in the realm of BAV and associated aortopathy from a genetic, morphologic, and clinical outcomes perspective in order to give the practicing clinician a deeper understanding of how to approach both medical and surgical decision-making in the patient with BAV. The following major principles have emerged in recent years including (1) the importance of cusp anatomy and its implications on the long-term risk of AI, aortic dilation, and aortic dissection, (2) the role of post-valvular flow dynamics in the pathogenesis of aortic dilation in BAV patients, (3) the ability of aortic valve replacement to halt accelerated dilation rates, and (4) the finding that the risk of aortic dissection, while still overall intermediate is much more akin to the baseline risk present in TAV patients rather than the much higher rates observed in patients with Marfan’s disease. Together, these data support the less aggressive approach to aortic replacement in BAV patients as reflected in the most recent ACC/AHA guidelines and provide a stronger basis upon which future studies, including those aimed at medical and transcatheter therapies, stand to make further impact on our ability to optimally treat this epidemiologically important and complex population of patients.
abstractGer	Opinion statement The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection. Because the understanding of the complexity of the BAV phenotype is evolving as quickly as are the options for medical, surgical, and interventional therapy, this review aims to provide an update on the most clinically relevant recent advances in the realm of BAV and associated aortopathy from a genetic, morphologic, and clinical outcomes perspective in order to give the practicing clinician a deeper understanding of how to approach both medical and surgical decision-making in the patient with BAV. The following major principles have emerged in recent years including (1) the importance of cusp anatomy and its implications on the long-term risk of AI, aortic dilation, and aortic dissection, (2) the role of post-valvular flow dynamics in the pathogenesis of aortic dilation in BAV patients, (3) the ability of aortic valve replacement to halt accelerated dilation rates, and (4) the finding that the risk of aortic dissection, while still overall intermediate is much more akin to the baseline risk present in TAV patients rather than the much higher rates observed in patients with Marfan’s disease. Together, these data support the less aggressive approach to aortic replacement in BAV patients as reflected in the most recent ACC/AHA guidelines and provide a stronger basis upon which future studies, including those aimed at medical and transcatheter therapies, stand to make further impact on our ability to optimally treat this epidemiologically important and complex population of patients.
abstract_unstemmed	Opinion statement The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection. Because the understanding of the complexity of the BAV phenotype is evolving as quickly as are the options for medical, surgical, and interventional therapy, this review aims to provide an update on the most clinically relevant recent advances in the realm of BAV and associated aortopathy from a genetic, morphologic, and clinical outcomes perspective in order to give the practicing clinician a deeper understanding of how to approach both medical and surgical decision-making in the patient with BAV. The following major principles have emerged in recent years including (1) the importance of cusp anatomy and its implications on the long-term risk of AI, aortic dilation, and aortic dissection, (2) the role of post-valvular flow dynamics in the pathogenesis of aortic dilation in BAV patients, (3) the ability of aortic valve replacement to halt accelerated dilation rates, and (4) the finding that the risk of aortic dissection, while still overall intermediate is much more akin to the baseline risk present in TAV patients rather than the much higher rates observed in patients with Marfan’s disease. Together, these data support the less aggressive approach to aortic replacement in BAV patients as reflected in the most recent ACC/AHA guidelines and provide a stronger basis upon which future studies, including those aimed at medical and transcatheter therapies, stand to make further impact on our ability to optimally treat this epidemiologically important and complex population of patients.
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title_short	Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making
url	https://dx.doi.org/10.1007/s11936-017-0569-8
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up_date	2024-07-03T16:37:12.174Z
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fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR023063386</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519140752.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201006s2017 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s11936-017-0569-8</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR023063386</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s11936-017-0569-8-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">ASE</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.85</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Kwon, Michael H.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2017</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Opinion statement The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection. Because the understanding of the complexity of the BAV phenotype is evolving as quickly as are the options for medical, surgical, and interventional therapy, this review aims to provide an update on the most clinically relevant recent advances in the realm of BAV and associated aortopathy from a genetic, morphologic, and clinical outcomes perspective in order to give the practicing clinician a deeper understanding of how to approach both medical and surgical decision-making in the patient with BAV. The following major principles have emerged in recent years including (1) the importance of cusp anatomy and its implications on the long-term risk of AI, aortic dilation, and aortic dissection, (2) the role of post-valvular flow dynamics in the pathogenesis of aortic dilation in BAV patients, (3) the ability of aortic valve replacement to halt accelerated dilation rates, and (4) the finding that the risk of aortic dissection, while still overall intermediate is much more akin to the baseline risk present in TAV patients rather than the much higher rates observed in patients with Marfan’s disease. Together, these data support the less aggressive approach to aortic replacement in BAV patients as reflected in the most recent ACC/AHA guidelines and provide a stronger basis upon which future studies, including those aimed at medical and transcatheter therapies, stand to make further impact on our ability to optimally treat this epidemiologically important and complex population of patients.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Bicuspid aortic valve</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Aortic insufficiency</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Aortic stenosis</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Tricuspid aortic valves</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Sundt, Thoralf M.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">Current treatment options in cardiovascular medicine</subfield><subfield code="d">Philadelphia, Pa. : Current Science Inc., 1999</subfield><subfield code="g">19(2017), 9 vom: 05. 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Bicuspid Aortic Valvulopathy and Associated Aortopathy: a Review of Contemporary Studies Relevant to Clinical Decision-Making

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