医学
二尖瓣
心脏病学
升主动脉
内科学
反流(循环)
狭窄
主动脉瓣
主动脉瘤
主动脉夹层
主动脉
人口
指南
病理
环境卫生
作者
Raj Verma,Gideon Cohen,Jillian Colbert,Paul W.M. Fedak
出处
期刊:Current Opinion in Cardiology
[Ovid Technologies (Wolters Kluwer)]
日期:2022-12-29
卷期号:38 (2): 61-67
被引量:6
标识
DOI:10.1097/hco.0000000000001020
摘要
Purpose of review Bicuspid aortic valve (BAV) disease is observed in 1–2% of the general population. In addition to valve-related complications (such as aortic stenosis and aortic regurgitation), individuals with BAV often develop dilatation of the proximal aorta (aortic root and ascending aorta), a condition termed BAV aortopathy. The development of BAV aortopathy can occur independent of valvular alterations and can lead to aneurysm formation, aortic dissection or aortic rupture. This review aims to update the clinician with an approach to BAV aortopathy decision making in keeping with the 2022 American College of Cardiology (ACC)/American Heart Association (AHA) Guideline recommendations. Recent findings The ACC/AHA 2022 guidelines provide a contemporary and comprehensive approach to the diagnosis and treatment of aortic pathologies. We review the thresholds for replacement of the aortic root and/or ascending aorta along with the strength and level of evidence recommendations. We also review the various Class 2A and 2B recommendations for earlier intervention, which emphasize the importance of experienced surgeons, and multidisciplinary aortic teams (MATs). Summary BAV aortopathy is a common and heterogenous clinical problem. The decision making around timing of intervention requires a personalized approach that is based on the aortic dimensions, valve function, rate of growth, family history, patient factors, and surgical experience within MATs.
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