VAN ĐỘNG MẠCH CHỦ HAI MẢNH ( BICUSPID AORTIC VALVE BAV )

CASE LÂM SÀNG Bệnh nhân nam, 37 tuổi, đến khám lần đầu MEDIC 072022 vì huyết áp cao chưa kiểm soát được, huyết áp cao nhất 240 mmHg. Thỉnh thoảng ran ngực nhẹ khi gắng sức Tim: không âm thổi Các cơ quan khác: tổn thương vẩy nến

VAN ĐỘNG MẠCH CHỦ HAI MẢNH

( BICUSPID AORTIC VALVE - BAV )

BS PHAN THỊ MINH NGA PHÒNG TĂNG HUYẾT ÁP

Trung Tâm Chẩn Đoán Y Khoa 1

CASE LÂM SÀNG

- Bệnh nhân nam, 37 tuổi, đến khám lần đầu MEDIC

07/2022 vì huyết áp cao chưa kiểm soát được, huyết áp cao nhất 240 mmHg

-Thỉnh thoảng ran ngực nhẹ khi gắng sức

-Tim: không âm thổi

-Các cơ quan khác: tổn thương vẩy nến

2

BICUSPID AORTIC VALVE

EPIDEMIOLOGY

• Approximately 1% to 2% of the population

More prevalent in men, accounting for 70% to 80% of cases

• In a subset of patients with BAV, familial clustering

consistent with an autosomal dominant inheritance

• In some families with BAV and associated congenital

anomalies, a mutation in the NOTCH1 gene has been

described

10

11

12

PATHOPHYSIOLOGY BAV

• Bicuspid aortic valve disease is associated with an

AORTOPATHY, with DILATION OF THE ASCENDING AORTA,

related to accelerated degeneration of the aortic media

• The risk of AORTIC DISSECTION in patients with BAV is five

to nine times higher than the general population, but the absolute

risk is still quite low

13

14

CLINICAL PRESENTATION

•

Patients with BAV may be diagnosed :

• At any age on the basis of the presence of an aortic

ejection sound or a systolic or diastolic murmur

15

DISEASE COURSE

subset of patients present in childhood or adolescence with valve

dysfunction.

and moderate or severe AR or AS

States and is a common cause of calcific AS, even in older persons.

16

• Currently, there are no effective medical therapies to prevent

progressive valve deterioration when a bicuspid valve is diagnosed

• The management of BAV disease is directed toward the

hemodynamic consequences of valve dysfunction —AS or AR—as discussed earlier.

18

Operative Procedures

19

BICUSPID AORTIC VALVE

Arnold Schwarzenegger

1947 (age 75)

aortic valve surgery.

surgery, Schwarzenegger underwent

a surgery for a new aortic valve.

24

Braunwald ‘s Heart Disease 2022

Braunwald ‘s Heart Disease 2018

UptoDate

25

− THANK YOU

26