Cecconi Moreno, Nistri Stefano, Quarti Andrea, Manfrin Marcello, Colonna Pier Luigi, Molini Epifanio, Perna Gian Piero
Presidio Monospecialistico di Alta Specializzazione 'G.M. Lancisi', Ospedali Riuniti Umberto I - G.M. Lancisi - G. Salesi, Ancona, Italy.
J Cardiovasc Med (Hagerstown). 2006 Jan;7(1):11-20. doi: 10.2459/01.JCM.0000199777.85343.ec.
The association of a bicuspid aortic valve (BAV) with abnormalities of the proximal thoracic aorta, including dilatation, aneurysm and dissection, has been previously described, leading to the hypothesis of a common underlying developmental defect involving the aortic valve and the aortic wall. Consequently, any patient with BAV should receive a careful assessment not only of the valve function, but also of the aortic root and the ascending aorta. Dilatation of the proximal thoracic aorta is a common finding in patients with BAV and is believed to be related to aortic rupture and dissection. Because progressive dilatation can occur, careful long-term surveillance of the aortic dimensions is required. Prophylactic surgical repair of the dilated aorta should be recommended more aggressively for patients with BAV than for those with a tricuspid aortic valve. However, the optimal timing of aortic surgery in BAV patients remains uncertain because of the limited data available on the natural history of asymptomatic aortic dilatation.
先前已描述过二叶式主动脉瓣（BAV）与胸段主动脉近端异常（包括扩张、动脉瘤和夹层）之间的关联，由此产生了一种假说，即存在涉及主动脉瓣和主动脉壁的共同潜在发育缺陷。因此，任何患有BAV的患者不仅应接受仔细的瓣膜功能评估，还应接受主动脉根部和升主动脉的评估。胸段主动脉近端扩张在BAV患者中很常见，并且被认为与主动脉破裂和夹层有关。由于可能会发生进行性扩张，因此需要对主动脉尺寸进行仔细的长期监测。对于患有BAV的患者，应比患有三尖瓣主动脉瓣的患者更积极地推荐对扩张主动脉进行预防性手术修复。然而，由于关于无症状主动脉扩张自然史的可用数据有限，BAV患者主动脉手术的最佳时机仍不确定。
