Normal and abnormal development of the aortic valve and ascending aortic wall: a comprehensive overview of the embryology and pathology of the bicuspid aortic valve.

Autor:	Grewal N; Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.; Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands.; Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands., Gittenberger-de Groot AC; Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.; Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands.; Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands.; Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands.; Institute of Biology, Animal Sciences and Health, Leiden University, Leiden, The Netherlands.; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands., Lindeman JH; Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands., Klautz A; Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands., Driessen A; Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands., Klautz RJM; Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.; Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands., Poelmann RE; Institute of Biology, Animal Sciences and Health, Leiden University, Leiden, The Netherlands.; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Jazyk:	angličtina
Zdroj:	Annals of cardiothoracic surgery [Ann Cardiothorac Surg] 2022 Jul; Vol. 11 (4), pp. 380-388.
DOI:	10.21037/acs-2021-bav-14
Abstrakt:	A bicuspid aortic valve (BAV) is the most prevalent congenital cardiac anomaly, in which the valve has only two leaflets, instead of the normal three. Patients with a BAV have an increased risk of aneurysm formation and the development of an aortic dissection. Vascular smooth muscle cells in both the non- and dilated aortic wall are characterized by a maturation defect in all BAV patients, as compared to patients with a tricuspid aortic valve, which can contribute to inherent developmental susceptibility. Besides structural abnormalities of the vascular wall, a turbulent blood flow, caused by bicuspid valve geometry, could expedite the pathological process in the aortic wall, leading to aortopathy. Although the risk for aortopathy is significant, not all BAV patients experience (acute) aortic complications in their lifespan, highlighting the complexity of the pathogenetic process. Recent studies have focused on the embryonic development of semilunar valves and the ascending aortic wall. Their findings highlight that a defect in the embryogenesis could not only explain the development of a malformed aortic valve but also the increased risk for ascending aorta and arch pathology. This review presents an overview of the normal and abnormal development of the aortic valve and the aortic wall: a common defect in early embryogenesis causes the development of a BAV and associated aortopathy. Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare. (2022 Annals of Cardiothoracic Surgery. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu