Aortic Dilatation in Patients With Bicuspid Aortic Valve

Figures

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  FIGURE 1. Anatomical feature of aorta and schematic diagram (A), and possible patterns of aortic dilatation associated with BAV according to the three classifications (B).

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  FIGURE 2. Wall shear stress heat maps and elastin fiber staining of BAV aorta wall. Aortic wall (A–C denote three different BAV aortas) from regions of high WSS (right panels; closed circles) had fewer elastin fibers (black) that were thinner and farther apart compared with regions with normal WSS (left panels; open circles) in the same human aortas (40 × magnification). Samples were collected from zone 1, 2, or 3, and from either the greater curvature, lesser curvature, anterior wall or posterior wall; accompanying diameters for tissue collection sites are shown. Gray denotes normal WSS, within the 95% confidence interval, compared with a healthy tricuspid aortic valve population; red and purple denote elevated and depressed WSS, respectively. Insets show steady-state free precession images of the aortic valve and Sievers valve phenotype. 3D, three-dimensional. Adapted with permission (Guzzardi et al., 2015).

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  FIGURE 3. In order to better understand the status of aortic dilatation in patients with BAV and the direction of further research, a brief diagram is provided. Includes natural progression (aortic aneurysm and aortic dissection/rupture), pathogenetic mechanisms (pathophysiology and hemodynamics), multimodal imaging technology (echocardiography, CTA, MRI), and treatment strategies.