CORRELATION BETWEEN BICUSPID AORTIC VALVE STENOSIS AND ASCENDING AORTIC ANEURYSMS: A SHORT REVIEW

Abstract

Bicuspid aortic valve (BAV) is the most common congenital cardiac valve abnormality and is frequently associated with progressive aortic valve stenosis and ascending aortic aneurysm. The coexistence of these conditions represents a significant clinical challenge because both altered hemodynamic forces and intrinsic abnormalities of the aortic wall contribute to disease progression. This mini-review summarizes the current understanding of the relationship between bicuspid aortic valve stenosis and ascending aortic aneurysms, focusing on epidemiology, pathophysiological mechanisms, clinical presentation, diagnostic evaluation, and contemporary management strategies. Evidence suggests that abnormal extracellular matrix remodeling, genetic susceptibility, and increased wall shear stress generated by the bicuspid valve all play important roles in the development of ascending aortic dilation. Although the severity of aortic stenosis does not consistently correlate with aneurysm size, patients with BAV remain at increased risk of progressive aortic enlargement and, less commonly, aortic dissection. Echocardiography, computed tomography, and magnetic resonance imaging are essential for diagnosis and long-term surveillance. Current management emphasizes individualized risk assessment, optimal timing of surgical intervention, and lifelong imaging follow-up. Continued advances in cardiovascular imaging and molecular research are expected to improve risk stratification and guide future therapeutic approaches for patients with bicuspid aortic valve disease.