Elevated Aortic Wall Shear Stress in a Subgroup of Patients with Bicuspid Valves

Michael D. Hope¹, Thomas A. Hope¹, Thomas H. Urbania¹, Karen G. Ordovas¹, Alison K. Meadows¹, Marcus T. Alley², Charles B. Higgins¹

4D Flow demonstrates significantly higher aortic wall shear stress in a subgroup of BAV patients with eccentric systolic flow jets. Studies have shown that only a subset of BAV patients have aortic dilation, and that those with dilation develop asymmetric aneurysms of the AsAo at the location where we have demonstrated elevated vWSS. As altered WSS can give rise to pathologic endothelial gene expression and extracellular matrix remodeling, we may have identified the mechanism that places a subgroup of BAV patients at risk for asymmetric AsAo aneurysm.