BAV and Thoracic Aneurysm

[WeirsGuy]

I had my bicuspid valve replaced two years ago with a bovine valve.
The BAV had caused enlargment of Thoracic aorta but it was deemed not big enough (4.5cm) during surgery to replace.
Just curious if replacing BAV with new valved is known to slow enlargement of Thoracic aneurysms

 

[Warrick]

Seems theres nothing to predict if/when the artery will expand but this site explains a bit-
https://badaorta.com/double-trouble-bicuspid-aortic-valve-bav/
So the tissue of the ascending aorta is genetically abnormal in everyone with BAV, wether it results in aneurysm or not isnt guranteed but the chances it will are higher than the chance it wont unfortunately, around 2/3rds it will
Mine is at 4.1 cm.

Theres folks on here that have had redos due to aneurysm within a year or two and then others that have gone 10-20 years before a redo, although there are varying stats wether aneurysm will eventuate from what Iv read on here over the years imo I would sumise the stats are not in accordance with fact and its pretty well a certainty at some point

 

[epstns]

Maybe so, Warrick, but there are also those of us who are monitored and have no indication of aneurysm (yet?). I was diagnosed BAV in 2002, had valve replaced in 2011, and my echo's to date still show no issues.

I've never seen that "around 2/3" statistic. It does make sense to monitor, just not to expect it until something is noted.

 

[pellicle]

mainly to @WeirsGuy

but there are also those of us who are monitored and have no indication of aneurysm

monitoring and recording is the only way to go.

best be on top of it. Slow growth may mean monitoring is every 2 or more years.

 

[Warrick]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4682694/“It has been estimated that 50%–70% of individuals with BAV develop aortic dilatation. ”

https://www.frontiersin.org/articles/10.3389/fphys.2017.00397/full“Compared to the normal population, there is a significantly higher rate of dilation of the proximal aorta in patients with BAV (Della Corte et al., 2007). Della Corte et al. (2007) found that aortic dilation [an aortic ratio (measured diameter/expected diameter) >1.1] was present in 83.2% of patients with BAVs, 79% mid-ascending dilation and 58% root dilation in adults. ”

https://www.ahajournals.org/doi/10.1161/JAHA.118.010885“Bicuspid aortic valve (BAV) is the most common congenital cardiac abnormality. A thoracic aortic aneurysm (TAA) is present in ≈50% of BAV patients, who also have an 8‐fold higher risk of aortic dissection than the general population. ”

 

[WeirsGuy]

Thanks all.

 

[bizinsider]

In addition to the very good studies/articles above, I found this one to be very thorough and will likely give you good insight. Enjoy! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6413866/

 

[Warrick]

From the above link
“BAV are also known to have an increased prevalence of anterior mitral valve leaflet elongation and prolapse”

First time I have read of this association

 

[pellicle]

First time I have read of this association

how's your Mitral doin?

 

[user 16827]

CONCLUSIONS:
We provide evidence that the cardiovascular alterations observed in the BAV are not limited to the aortic valve or ascending aorta but also involve the AML, and seem to be more pronounced in patients with a BAV with concomitant, clinically significant aortic regurgitation.

Something else for me to worry about

thanks @Warrick

 

[Warrick]

From an echo I had 12 months “There is calcification of the anterior MVL”

Hmm know how you feel lol ...

 

[pellicle]

From an echo I had 12 months “There is calcification of the anterior MVL”

fukked innit ... still, gotta die of something

 

[bobr33543]

8 years post op AVR for BAV, no aneurism found on echoes every 2 years.