Key result
A 33-year-old male with a bicuspid aortic valve and Stanford type A aortic dissection was successfully treated with a Bentall and Bono procedure after presenting with heart failure and syncope.
Why the study?
Bicuspid aortic valve disease involves complex genetic alterations causing aortopathy and complications such as Stanford type A dissection, which can present atypically.
Case Report (n=1)
Highlights the complexity and severe complications, such as Stanford type A aortic dissection, that can arise in patients with bicuspid aortic valve disease.
Does not support practice change for bicuspid aortic valve; extends case reports of type A dissection but leaves optimal surveillance open.
Bicuspid aortic valve disease (BAV) is a congenital disease that frequently produces complications during adulthood, and is considered not only a problem of valvulogenesis, but also a more complex genetic alteration that involves the development of the heart and the aorta, which entails a high morbidity and mortality in these patients. In 50% of adults with this pathology, non-valvular anomalies are observed, with dilation of the ascending aorta being the most common. Genes such as NOTCH1, UFDL1, ACTA2, eNOS, among others, have been identified as responsible for the appearance of aneurysms, which increases the risk in these patients of complications such as aortic dissection and its subsequent rupture. Painless aortic dissection may be seen in less than 5% of patients and may have an atypical clinical presentation. A case and review of the literature is presented in which we can observe the great complexity of this pathology, in the case of a patient with BAV, annulo-ectatic dilation of the aortic root and ascending aorta who developed heart failure, syncope and presented as a complication Stanford type A aortic dissection, requiring highly specialized surgical treatment.
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Ordóñez et al. (2023) conducted a case report in Bicuspid aortic valve with Stanford Type A aortic dissection (n=1). Bentall and Bono surgery was evaluated. A 33-year-old male with a bicuspid aortic valve and Stanford type A aortic dissection was successfully treated with a Bentall and Bono procedure after presenting with heart failure and syncope.
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