Ricerc@Sapienza

Bicuspid aortic valve (BAV) disease is the most common congenital cardiac malformation associated with an increased lifetime risk and a high rate of surgically-relevant valve deterioration and aortic dilatation. Genomic data revealed that different genes are associated with BAV. A dominant genetic factor for the recent past was the basis to the recommendation for a more extensive aortic intervention.

Research on bicuspid aortic valve disease (BAV) and related com- plications has grown in an exponential manner in the last decades. However, the current knowledge of the mechanisms underlying the development of this disease is still limited, since all clinical and surgical studies on BAV mainly focused their objects on its major vascular complications, such as ascending aortic aneurysms and dissection.

The prevalence of valvular heart disease (VHD) rises with age, reaching 11.7% in individuals older than 75 years.1 In young individuals, VHD is usually related to the presence of a congenital valve abnormality, as bicuspid aortic valve (BAV) or mitral valve prolapse. This is also the case for athletes, where in the presence of these abnormalities few restrictions exist in eligibility

Background: Significant aortic stenosis can be effectively treated with transcatheter aortic valve implantation (TAVI) in patients at high or intermediate surgical risk. Predilation is often performed to facilitate TAVI implantation, but its risk-benefit balance with new-generation devices is detabed. We aimed to appraise whether predilation is still needed with new-generation devices for TAVI.

Cardiovascular magnetic resonance (CMR) has an emerging role in aortic valve disease evaluation (AVD), becoming an all-in-one technique. CMR evaluation of the anatomy and flow through the aortic valve has a higher reproducibility than echocardiography. Its unique ability of in-vivo myocardial tissue characterization, significantly improves the risk stratification and management of patients.