Bicuspid Aortic Valve
BAV occurs in up to 2% of the population, rendering it the most common
congenital cardiac malformation30. Investigating BAV
may require other modalities than echocardiography, such as CT or MRI,
due to the location of the dilatation (distal ascending
aorta)5. BAV is regarded as low risk for dissection,
at less than 1%5. Immer et al. found 10% of
patients in their patients had BAV in their analysis of risk factors for
AD during pregnancy; they were observed to be younger than patients with
MFS (not significant), and dissections occurred earlier in pregnancy
(p<0.05)28. Immer et al . warned that
aortic root diameter in BAV >40mm was at risk of TAAD. The
recommended requirement for elective aortic root surgery in BAV is 47mm
and above5. A literature review by Yuan found 11
reports of AD in pregnant women with BAV30. 4 out of
11 women also had MFS or TS. The aortic diameter ranged between 29-70mm
in these women, occurring even prior to reaching 40mm. Ascending aorta
greater than 50mm is recommended for women not to become
pregnant5.