Division of Cardiothoracic Surgery, Alpert School of Medicine at Brown University, Rhode Island Hospital, Two Dudley Street, Suite 500, Providence, RI 02905, USA.
Cardiol Clin. 2010 May;28(2):299-314. doi: 10.1016/j.ccl.2010.02.003.
Bicuspid aortic valve (BAV)-associated aortopathy is a complex phenomenon, and the current lack of univocal interpretation of its causes and treatment can be ascribed to the multiform nature of its clinical presentation. Although there is strong bias in the literature favoring more aggressive treatment of ascending aortic dilatation in patients with BAV, evidence supporting this opinion is lacking. This review discusses some of the relevant issues relating to causation to facilitate a better analysis of the current recommendations used to guide surgical management, and concludes that treatment should be tailored by individual valvular pathology, clinical phenotype, and relevant comorbidities, using well-documented evidence-based clinical size criteria.
二叶式主动脉瓣（BAV）相关的主动脉病变是一种复杂的现象，目前对于其病因和治疗缺乏明确的解释，可以归因于其临床表现的多样性。尽管文献中存在强烈的倾向，即支持对 BAV 患者的升主动脉扩张进行更积极的治疗，但缺乏支持这种观点的证据。本文讨论了与病因相关的一些相关问题，以帮助更好地分析目前用于指导手术管理的建议，并得出结论，治疗应根据个体瓣膜病变、临床表型和相关合并症进行调整，使用有充分记录的基于证据的临床大小标准。
