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Clinical implications of the biomechanics of bicuspid aortic valve and bicuspid aortopathy

Journal

FRONTIERS IN CARDIOVASCULAR MEDICINE
Volume 9, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fcvm.2022.922353

Keywords

bicuspid aortic valve; bicuspid aortopathy; biomechanics; BAV-mediated hemodynamics; 4D flow MRI

Funding

  1. University of Calgary URGC SEM [1054341]
  2. Natural Sciences and Engineering Research Council of Canada/Conseil de recherche en sciences naturelles et en genie du Canada [RGPIN-2020-04549, DGECR-2020-00204]

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This article presents the latest research on the biomechanics of bicuspid aortic valve (BAV), including definitions and classifications, mechanisms driving valve disease, and the impact of abnormal flow patterns on aortic dilatation. The role of cardiac magnetic resonance imaging in assessing and managing patients with BAV and bicuspid aortopathy is also discussed.
Bicuspid aortic valve (BAV), which affects up to 2% of the general population, results from the abnormal fusion of the cusps of the aortic valve. Patients with BAV are at a higher risk for developing aortic dilatation, a condition known as bicuspid aortopathy, which is associated with potentially life-threatening sequelae such as aortic dissection and aortic rupture. Although BAV biomechanics have been shown to contribute to aortopathy, their precise impact is yet to be delineated. Herein, we present the latest literature related to BAV biomechanics. We present the most recent definitions and classifications for BAV. We also summarize the current evidence pertaining to the mechanisms that drive bicuspid aortopathy. We highlight how aberrant flow patterns can contribute to the development of aortic dilatation. Finally, we discuss the role cardiac magnetic resonance imaging can have in assessing and managing patient with BAV and bicuspid aortopathy.

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