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Controversies exist regarding aortic disease imaging (the aorta as well as the aortic valve, including characterization in the presence of a bicuspid aortic valve (BAV)). Many imaging approaches are optimized for evaluation of coronary artery disease rather than aortic disease. Without accurate characterization, the degree of disease progression may be under estimated, patient symptoms may be discounted, and those who ...more »
Controversies exist regarding the treatment of the thoracic aorta in those with bicuspid aortic valve (BAV), in particular: 1) conflicting views regarding criteria for elective surgery, particularly aneurysm size 2) extent of thoracic aortic aneurysm repair.
Greater understanding of the incidence, associated mortality, and unique characteristics of bicuspid aortic valve (BAV) and thoracic aortic disease are needed. An increase in autopsies would be an important source in advancing understanding.
Clinical disease manifestations in individuals and families where bicuspid aortic valve is present may best be described as a spectrum, with considerable variability in presentation. Patients and families would benefit from an individualized approach, which does include familial medical history, but couples that information with current best understanding of BAV, considering both variations and risks.
There is a persistent perception that bicuspid aortic valve (BAV), the most common congenital heart defect (estimated to occur in up to 6 million Americans), is a benign condition that may not require treatment until later in life, if at all. The implications for other blood relatives, although referenced in medical literature, may not be acknowledged. This notion, coupled with the inability to identify those most at ...more »