Optimization of the management and timing of surgery of patients with bicuspid aortic valve stenosis to prevent complications

Stenosis of the aortic valve is the most common valvular disorder in the western world.

The bicuspid aortic valve (BAV), where the aortic valve have two instead of three leaflets, is the most common congenital heart disease and predisposes to stenosis of the aortic valve.

We have previousy demonstrated that patients with stenosis in the bicuspid aortic valve have a higher prevalence of heart failure at the time of surgery and that they have a higher prevalence of atrial fibrillation and stroke postoperatively than patients with stenosis in a normal aortic valve.In this project, we will make use of a well characterized patient cohort of aortic stenosis patients to decipher why patients with stenosis in the bicuspid valve are operated too late.

We will study if we underestimate the severity of obstruction of the valve in preoperative analysis, the recovery potential of the heart function after surgery, progress rate of the obstruction, biomarkers in the blood that signal deterioration of heart function as well as decipher mechanisms of heart failure and dilatation of the aorta using advanced proteomics analysis on heart and aortic biopsis harvested at the time of surgery.Our project has the potential for earlier detection, individualized medical and surgical treatment at the right time point, avoid heart failure and give patients better and longer lifes.

Better understanding of mechanisms behind aortic aneurysm and heart failure development might open up for new therapies.