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Grewal, N. (2015)

Aortopathy in patients with a bicuspid aortic valve : determining susceptibility for aortic complications

Doctoral Thesis
The prevalence of aortic dilation and related complications as rupture and dissection is higher in patients with a bicuspid aortic valve (BAV) as compared to patients with a tricuspid aortic valve (TAV), although not every individual carries this increased risk. It is therefore essential to identify those patients who are less susceptible for aortic wall pathology, as preventive ascending aortic surgery would not be necessary in this group. Since aortic diameter as a criterion for surgery is only decisive at population level, it would be very valuable to have tailored risk stratification at patient level. The purpose of this thesis was therefore to investigate the possibility to identify patients with BAV, without apparent dilation, with an increased susceptibility for future complications as aortic dilation and dissection. Furthermore the biological mechanism underlying aortic wall pathology in BAV was compared to a known genetically determined syndrome with an increased risk of...Show moreThe prevalence of aortic dilation and related complications as rupture and dissection is higher in patients with a bicuspid aortic valve (BAV) as compared to patients with a tricuspid aortic valve (TAV), although not every individual carries this increased risk. It is therefore essential to identify those patients who are less susceptible for aortic wall pathology, as preventive ascending aortic surgery would not be necessary in this group. Since aortic diameter as a criterion for surgery is only decisive at population level, it would be very valuable to have tailored risk stratification at patient level. The purpose of this thesis was therefore to investigate the possibility to identify patients with BAV, without apparent dilation, with an increased susceptibility for future complications as aortic dilation and dissection. Furthermore the biological mechanism underlying aortic wall pathology in BAV was compared to a known genetically determined syndrome with an increased risk of aortopathy being Marfan syndrome.Show less
Susceptibility
Marfan Syndrome
Congenital
Bicuspid Aortic Valve
Aortopathy
Aorta
Aneurysm
All authors
Grewal, N.
Supervisor
Klautz, R.J.M.; Ruiter, M.C. de
Qualification
Doctor (dr.)
Awarding Institution
Leiden University Medical Center (LUMC), Leiden University
Date
2015-02-19
ISBN (print)
9789462595514