Aorta bivalva

Aorta Bivalva; Por: Dr. Ricardo Mora Moreno MAECO (Medico en adiestramiento ecocardiografico); IMSS CMN SS XXI Hospital de Cardiología, servicio de Ecocardiografia, CDMX, 29 Agosto 2019

1. Instituto Mexicano del Seguro Social Centro Médico Nacional Siglo XXI Hospital de Cardiología Servicio de Ecocardiografía CMN Siglo XXI “Aorta Bivalva” Dr. Ricardo Mora Moreno (MAECO) Ciudad de México 29/ Agosto / 2019

2. Aorta Bivalva: Generalidades Anomalía congénita Incidencia: 1% de la población Afección de novo o Autosómica dominante (penetración variable) Afección aortica: regurgitación y/o estenosis Riesgo de endocarditis Dilatación de raíz aortica y/o aorta ascendente Braverman AC. The Bicuspid Aortic Valve and Associated Aortic Disease . In: Valvular Heart Disase , 4th, Otto CM, Bonow RO ( Eds ), Saunders/ Elsevier , Philadelpha 2013. p.179. Verma S, Siu SC. Aortic dilatation in patients with bicuspid aortic valve . N Engl J Med 2014; 370:1920. Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

3. Aorta Bivalva: Generalidades Incidencia: 1% de la población Genero: Masculino 2-3:1 Femenino Grupos con mayor prevalencia: Coartación aortica 30-50% Sx Turner 30% Braverman AC. The Bicuspid Aortic Valve and Associated Aortic Disease . In: Valvular Heart Disase , 4th, Otto CM, Bonow RO ( Eds ), Saunders/ Elsevier , Philadelpha 2013. p.179. Verma S, Siu SC. Aortic dilatation in patients with bicuspid aortic valve . N Engl J Med 2014; 370:1920. Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

4. Aorta Bivalva: Generalidades Braverman AC. The Bicuspid Aortic Valve and Associated Aortic Disease . In: Valvular Heart Disase , 4th, Otto CM, Bonow RO ( Eds ), Saunders/ Elsevier , Philadelpha 2013. p.179. Verma S, Siu SC. Aortic dilatation in patients with bicuspid aortic valve . N Engl J Med 2014; 370:1920. Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

5. Aorta Bivalva: Asociaciones Braverman AC. The Bicuspid Aortic Valve and Associated Aortic Disease . In: Valvular Heart Disase , 4th, Otto CM, Bonow RO ( Eds ), Saunders/ Elsevier , Philadelpha 2013. p.179. Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

6. Aorta Bivalva: Dilatación Aortica Abbott ME. Coarctation of the aorta of the adult type: II. A statistical study and historical retrospect of 200 recorded cases with autopsy, of stenosis or obliteration of the descending arch in subjects above the age of two years. Am Heart J 1928; 3:574. Barker AJ, Markl M, Bürk J, et al. Bicuspid aortic valve is associated with altered wall shear stress in the ascending aorta. Circ Cardiovasc Imaging 2012; 5:457. Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

7. Aorta Bivalva: Cuadro clínico Braverman AC. The Bicuspid Aortic Valve and Associated Aortic Disease . In: Valvular Heart Disase , 4th, Otto CM, Bonow RO ( Eds ), Saunders/ Elsevier , Philadelpha 2013. p.179. Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

8. Aorta Bivalva: Dx Ayad RF, Grayburn PA, Ko JM, et al. Accuracy of two -dimensional echocardiography in determining aortic valve structure in patients >50 years of age having aortic valve replacement for aortic stenosis . Am J Cardiol 2011; 108:1589. Hillebrand M, Koschyk D, Ter Hark P, et al. Diagnostic accuracy study of routine echocardiography for bicuspid aortic valve : a retrospective study and meta- analysis . Cardiovasc Diagn Ther 2017; 7:367. Tanaka R, Yoshioka K, Niinuma H, et al. Diagnostic value of cardiac CT in the evaluation of bicuspid aortic stenosis : comparison with echocardiography and operative findings . AJR Am J Roentgenol 2010; 195:895. Gleeson TG, Mwangi I, Horgan SJ, et al. Steady-state free- precession (SSFP) cine MRI in distinguishing normal and bicuspid aortic valves . J Magn Reson Imaging 2008; 28:873. Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

9. Aorta Bivalva: Clasificación Saber et al, Mayo Clin Proc , 1999; 74:14-26. Tipo 1 Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

10. Aorta Bivalva: Clasificación Patrón Fusión Saber et al, Mayo Clin Proc , 1999; 74:14-26. Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

11. Aorta Bivalva: Clasificación Orientación comisural Saber et al, Mayo Clin Proc , 1999; 74:14-26. 180º 179-121º 120º Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

12. Aorta Bivalva: Clasificación Saber et al, Mayo Clin Proc , 1999; 74:14-26. Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

13. Aorta Bivalva: Clasificación Hans-H Sievers , A classification system for the bicuspid aortic valve from 304 surgical specimens . J Thorac CV Surgery , 2007; 1226-33. Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

14. Caso #1 Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

15. Caso #2 Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

16. Caso #3 Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva

17. Gracias! Dr. Ricardo Mora Moreno (MAECO) Aorta Bivalva