Bicuspid Aortic Valve: From pathophysiological mechanisms, imaging diagnosis to clinical treatment methods

Bicuspid Aortic Valve (BAV) is a common malformation affecting 0.5%-2% of the general population. BAV has a wide range of clinical presentations and consequences, such as aortic stenosis, regurgitation, aortic dissection, and bacterial endocarditis. However, there is a lack of effective clinical or molecular markers to predict associated complications. Bicuspid aortic stenosis is one of the most encountered complications in patients with BAV, which accounts for almost 50% of isolated severe aortic stenosis cases requiring surgery. The genetics and pathophysiology behind bicuspid aortic stenosis are believed to be different from a normal tricuspid aortic valve, given that the varied anatomy such as extensive leaflet calcification, raphe or aortopathy seen in BAV and that patients with bicuspid aortic stenosis develop symptoms at a younger age. Despite the advent of transcatheter aortic valve replacement, bicuspid aortic stenosis has long been regarded as a challenging anatomy for not behaving the same with tricuspid aortic stenosis. With the evidence of treating bicuspid aortic stenosis accumulating, new strategies and innovations have been emerging to improve clinical outcomes in BAV patients.

In this issue focusing on Bicuspid Aortic Valve, we would like to create a forum for research that tackles the difference or uniqueness of the BAV entity, from genetic, cellular, and pathophysiological mechanisms of BAV and the subsequent bicuspid aortic stenosis, clinical imaging for bicuspid aortic stenosis to unveil its function and anatomy, treatment innovations and strategies tailored for bicuspid aortic stenosis, to clinical outcomes. Transcatheter aortic valve replacement has increasingly been used in this challenging anatomy, research concerning novel planning and technical considerations for bicuspid aortic stenosis will be particularly welcomed.

We welcome Original Research, Review, Mini Review, Methodology Papers and Case Reports on the sub-topics below:
1) Pathobiology and genetics that contribute to bicuspid aortic stenosis and disease progression.
2) Natural history or epidemiological features of bicuspid aortic stenosis.
3) Advanced imaging for accurate BAV diagnosis, phenotyping and structural measurements, especially procedure related imaging.
4) Clinical outcomes of invasive treatment to bicuspid aortic stenosis, preferably being compared with tricuspid aortic stenosis.
5) Novel strategies and innovations proposed for bicuspid aortic stenosis.
6) Formation of aortic aneurysm in BAV patients associated with Extracellular Matrix (ECM) pathology.