Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy.
Evolution of Precision Medicine and Surgical Strategies for Bicuspid Aortic Valve-Associated Aortopathy.
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DOI：
10.3389/fphys.2017.00475
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发表时间：
2017
影响因子：
4
通讯作者：
Fedak PWM
中科院分区：
文献类型：
--
作者：
Fatehi Hassanabad A;Barker AJ;Guzzardi D;Markl M;Malaisrie C;McCarthy PM;Fedak PWM
二叶式主动脉瓣（BAV）是一种常见的先天性心脏畸形，影响1-2%的人。BAV由两个相邻主动脉瓣尖融合引起，并与主动脉扩张相关，称为二尖瓣相关性动脉病。二尖瓣病变是进行性的，并与灾难性的临床事件有关，如主动脉夹层和破裂。因此，经常建议进行频繁监测和早期干预，并对近端主动脉进行预防性手术切除。然而，升主动脉病变的具体模式在患者之间差异很大，不同节段的升主动脉受到影响。个体患者的风险有时很难预测。切除策略由当前的手术指南告知，该指南主要基于主动脉尺寸和生长标准。这些标准可能不能最佳地反映重要主动脉事件的风险。为了解决二尖瓣病变患者护理中的这些问题，我们的转化研究小组专注于验证新型成像技术的使用，以确定BAV患者风险分层的非侵入性血流动力学生物标志物。在这篇文章中，我们回顾了最近的努力，成功，和持续的挑战，在发展更精确和个性化的手术方法，为患者的二叶式主动脉瓣和相关的主动脉疾病。
Bicuspid aortic valve (BAV) is a common congenital cardiac malformation affecting 1–2% of people. BAV results from fusion of two adjacent aortic valve cusps, and is associated with dilatation of the aorta, known as bicuspid valve associated aortopathy. Bicuspid valve aortopathy is progressive and associated with catastrophic clinical events, such as aortic dissection and rupture. Therefore, frequent monitoring and early intervention with prophylactic surgical resection of the proximal aorta is often recommended. However, the specific pattern of aortopathy is highly variable among patients, with different segments of the ascending aorta being affected. Individual patient risks are sometimes difficult to predict. Resection strategies are informed by current surgical guidelines which are primarily based on aortic size and growth criteria. These criteria may not optimally reflect the risk of important aortic events. To address these issues in the care of patients with bicuspid valve aortopathy, our translational research group has focused on validating use of novel imaging techniques to establish non-invasive hemodynamic biomarkers for risk-stratifying BAV patients. In this article, we review recent efforts, successes, and ongoing challenges in the development of more precise and individualized surgical approaches for patients with bicuspid aortic valves and associated aortic disease.
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双脊肉主动脉瓣疾病的手术治疗：知识差距和研究观点。
影响因子：
6
作者：
Della Corte, Alessandro;Body, Simon C.;Booher, Anna M.;Schaefers, Hans-Joachim;Milewski, Rita K.;Michelena, Hector I.;Evangelista, Arturo;Pibarot, Philippe;Mathieu, Patrick;Limongelli, Giuseppe;Shekar, Prem S.;Aranki, Sary F.;Ballotta, Andrea;Di Benedetto, Giuseppe;Sakalihasan, Natzi;Nappi, Gianantonio;Eagle, Kim A.;Bavaria, Joseph E.;Frigiola, Alessandro;Sundt, Thoralf M.
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影响因子：
3.3
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DOI：
10.1186/1532-429x-14-84
发表时间：
2012-12-13
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
Bürk J;Blanke P;Stankovic Z;Barker A;Russe M;Geiger J;Frydrychowicz A;Langer M;Markl M
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Markl M
影响因子：
2.4
作者：
Cibis M;Jarvis K;Markl M;Rose M;Rigsby C;Barker AJ;Wentzel JJ
通讯作者：
Wentzel JJ
DOI：
10.1016/s0022-5223(99)70002-4
发表时间：
1999-10-01
影响因子：
6
作者：
de Sa, M;Moshkovitz, Y;David, TE
通讯作者：
David, TE