International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes

Hector I. Michelena; Alessandro Della Corte; Arturo Evangelista; Joseph J. Maleszewski; William D. Edwards; Mary J. Roman; Richard B. Devereux; Borja Fernández; Federico M. Asch; Alex J. Barker; Lilia M. Sierra-Galan; Laurent De Kerchove; Susan M. Fernandes; Paul W.M. Fedak; Evaldas Girdauskas; Victoria Delgado; Suhny Abbara; Emmanuel Lansac; Siddharth K. Prakash; Malenka M. Bissell; Bogdan A. Popescu; Michael D. Hope; Marta Sitges; Vinod H. Thourani; Phillippe Pibarot; Krishnaswamy Chandrasekaran; Patrizio Lancellotti; Michael A. Borger; John K. Forrest; John Webb; Dianna M. Milewicz; Raj Makkar; Martin B. Leon; Stephen P. Sanders; Michael Markl; Victor A. Ferrari; William C. Roberts; Jae Kwan Song; Philipp Blanke; Charles S. White; Samuel Siu; Lars G. Svensson; Alan C. Braverman; Joseph Bavaria; Thoralf M. Sundt; Gebrine El Khoury; Ruggero De Paulis; Maurice Enriquez-Sarano; Jeroen J. Bax; Catherine M. Otto; Hans Joachim Schäfers

doi:10.1016/j.athoracsur.2020.08.119

International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes

Hector I. Michelena, Alessandro Della Corte, Arturo Evangelista, Joseph J. Maleszewski, William D. Edwards, Mary J. Roman, Richard B. Devereux, Borja Fernández, Federico M. Asch, Alex J. Barker, Lilia M. Sierra-Galan, Laurent De Kerchove, Susan M. Fernandes, Paul W.M. Fedak, Evaldas Girdauskas, Victoria Delgado, Suhny Abbara, Emmanuel Lansac, Siddharth K. Prakash, Malenka M. BissellBogdan A. Popescu, Michael D. Hope, Marta Sitges, Vinod H. Thourani, Phillippe Pibarot, Krishnaswamy Chandrasekaran, Patrizio Lancellotti, Michael A. Borger, John K. Forrest, John Webb, Dianna M. Milewicz, Raj Makkar, Martin B. Leon, Stephen P. Sanders, Michael Markl, Victor A. Ferrari, William C. Roberts, Jae Kwan Song, Philipp Blanke, Charles S. White, Samuel Siu, Lars G. Svensson, Alan C. Braverman, Joseph Bavaria, Thoralf M. Sundt, Gebrine El Khoury, Ruggero De Paulis, Maurice Enriquez-Sarano, Jeroen J. Bax, Catherine M. Otto, Hans Joachim Schäfers

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Abstract

This International Consensus Classification and Nomenclature for the congenital bicuspid aortic valve condition recognizes 3 types of bicuspid valves: 1. The fused type (right-left cusp fusion, right-non-coronary cusp fusion and left-non-coronary cusp fusion phenotypes); 2. The 2-sinus type (latero-lateral and antero-posterior phenotypes); and 3. The partial-fusion (forme fruste) type. The presence of raphe and the symmetry of the fused type phenotypes are critical aspects to describe. The International Consensus also recognizes 3 types of bicuspid valve-associated aortopathy: 1. The ascending phenotype; 2. The root phenotype; and 3. Extended phenotypes.

Original language	English
Pages (from-to)	e203-e235
Journal	Annals of Thoracic Surgery
Volume	112
Issue number	3
DOIs	https://doi.org/10.1016/j.athoracsur.2020.08.119
State	Published - Sep 2021

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10.1016/j.athoracsur.2020.08.119

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Michelena, H. I., Della Corte, A., Evangelista, A., Maleszewski, J. J., Edwards, W. D., Roman, M. J., Devereux, R. B., Fernández, B., Asch, F. M., Barker, A. J., Sierra-Galan, L. M., De Kerchove, L., Fernandes, S. M., Fedak, P. W. M., Girdauskas, E., Delgado, V., Abbara, S., Lansac, E., Prakash, S. K., ... Schäfers, H. J. (2021). International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes. Annals of Thoracic Surgery, 112(3), e203-e235. https://doi.org/10.1016/j.athoracsur.2020.08.119

@article{aff56589da8a41f49ba102b88aa58ede,

title = "International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes",

abstract = "This International Consensus Classification and Nomenclature for the congenital bicuspid aortic valve condition recognizes 3 types of bicuspid valves: 1. The fused type (right-left cusp fusion, right-non-coronary cusp fusion and left-non-coronary cusp fusion phenotypes); 2. The 2-sinus type (latero-lateral and antero-posterior phenotypes); and 3. The partial-fusion (forme fruste) type. The presence of raphe and the symmetry of the fused type phenotypes are critical aspects to describe. The International Consensus also recognizes 3 types of bicuspid valve-associated aortopathy: 1. The ascending phenotype; 2. The root phenotype; and 3. Extended phenotypes.",

author = "Michelena, {Hector I.} and {Della Corte}, Alessandro and Arturo Evangelista and Maleszewski, {Joseph J.} and Edwards, {William D.} and Roman, {Mary J.} and Devereux, {Richard B.} and Borja Fern{\'a}ndez and Asch, {Federico M.} and Barker, {Alex J.} and Sierra-Galan, {Lilia M.} and {De Kerchove}, Laurent and Fernandes, {Susan M.} and Fedak, {Paul W.M.} and Evaldas Girdauskas and Victoria Delgado and Suhny Abbara and Emmanuel Lansac and Prakash, {Siddharth K.} and Bissell, {Malenka M.} and Popescu, {Bogdan A.} and Hope, {Michael D.} and Marta Sitges and Thourani, {Vinod H.} and Phillippe Pibarot and Krishnaswamy Chandrasekaran and Patrizio Lancellotti and Borger, {Michael A.} and Forrest, {John K.} and John Webb and Milewicz, {Dianna M.} and Raj Makkar and Leon, {Martin B.} and Sanders, {Stephen P.} and Michael Markl and Ferrari, {Victor A.} and Roberts, {William C.} and Song, {Jae Kwan} and Philipp Blanke and White, {Charles S.} and Samuel Siu and Svensson, {Lars G.} and Braverman, {Alan C.} and Joseph Bavaria and Sundt, {Thoralf M.} and {El Khoury}, Gebrine and {De Paulis}, Ruggero and Maurice Enriquez-Sarano and Bax, {Jeroen J.} and Otto, {Catherine M.} and Sch{\"a}fers, {Hans Joachim}",

note = "Funding Information: The authors wish to thank Carl Clingman, Senior Medical Illustrator, Biomedical & Scientific Visualization, Mayo Clinic and Pavel Zacek, Department of Cardiac Surgery, Charles University Hospital, Hradec Kralove, Czech Republic, for their illustrations. Conflict of interest: Victoria Delgado: discloses a financial relationship with Abbott Vascular, Edwards Lifesciences, GE Healthcare, MSD, Medtronic, and Novartis. Emmanuel Lansac: patent Extra Aortic ring annuloplasty device with Coroneo Inc. Phillippe Pibarot: funding from Edwards Lifesciences and Medtronic for echocardiography core laboratory services with no personal compensation. Michael A. Borger: discloses a financial relationship with Edwards Lifesciences, Medtronic, Abbott, and CryoLife. John K. Forrest: grant support and consultant to: Edwards Lifesciences, Medtronic Inc. John Webb: consultant to: Edwards Lifesciences, Abbott, Boston Scientific. Martin B. Leon: institutional clinical research grants from Abbott, BSC, Edwards and Medtronic. Michael Markl: research support—Siemens Healthineers, Research Grant—Circle Cardiovascular Imaging, Consulting—Circle Cardiovascular Imaging, Research Grant—CryoLife Inc. Victor A. Ferrari: Senior Advisory Board, Journal of Cardiovascular Magnetic Resonance. Philipp Blanke: consultant for Edwards Lifesciences and Circle Cardiovascular Imaging; and provides CT core lab services for Edwards Lifesciences, Medtronic, Neovasc, and Tendyne Holdings, for which he receives no direct compensation. Ruggero De Paulis: patent on aortic root graft with Terumo Aortic. Consultant for Edwards Lifesciences, Medtronic, and Terumo Aortic. Maurice Enriquez-Sarano: consulting fees from Edwards LLC, CryoLife, and ChemImage. The Department of Cardiology of the LUMC received unrestricted research grants from Abbott Vascular, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare, and Medtronic. The other authors report no conflict of interest. Funding Information: Conflict of interest: Victoria Delgado: discloses a financial relationship with Abbott Vascular, Edwards Lifesciences, GE Healthcare, MSD, Medtronic, and Novartis. Emmanuel Lansac: patent Extra Aortic ring annuloplasty device with Coroneo Inc. Phillippe Pibarot: funding from Edwards Lifesciences and Medtronic for echocardiography core laboratory services with no personal compensation. Michael A. Borger: discloses a financial relationship with Edwards Lifesciences, Medtronic, Abbott, and CryoLife. John K. Forrest: grant support and consultant to: Edwards Lifesciences, Medtronic Inc. John Webb: consultant to: Edwards Lifesciences, Abbott, Boston Scientific. Martin B. Leon: institutional clinical research grants from Abbott, BSC, Edwards and Medtronic. Michael Markl: research support—Siemens Healthineers, Research Grant—Circle Cardiovascular Imaging, Consulting—Circle Cardiovascular Imaging, Research Grant—CryoLife Inc. Victor A. Ferrari: Senior Advisory Board, Journal of Cardiovascular Magnetic Resonance. Philipp Blanke: consultant for Edwards Lifesciences and Circle Cardiovascular Imaging; and provides CT core lab services for Edwards Lifesciences, Medtronic, Neovasc, and Tendyne Holdings, for which he receives no direct compensation. Ruggero De Paulis: patent on aortic root graft with Terumo Aortic. Consultant for Edwards Lifesciences, Medtronic, and Terumo Aortic. Maurice Enriquez-Sarano: consulting fees from Edwards LLC, CryoLife, and ChemImage. The Department of Cardiology of the LUMC received unrestricted research grants from Abbott Vascular, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare, and Medtronic. The other authors report no conflict of interest. Publisher Copyright: {\textcopyright} 2021 Jointly between The Society of Thoracic Surgeons, the American Association for Thoracic Surgery, the European Association for Cardio-Thoracic Surgery, and the Radiological Society of North America",

year = "2021",

month = sep,

doi = "10.1016/j.athoracsur.2020.08.119",

language = "English",

volume = "112",

pages = "e203--e235",

journal = "Annals of Thoracic Surgery",

issn = "0003-4975",

number = "3",

}

Michelena, HI, Della Corte, A, Evangelista, A, Maleszewski, JJ, Edwards, WD, Roman, MJ, Devereux, RB, Fernández, B, Asch, FM, Barker, AJ, Sierra-Galan, LM, De Kerchove, L, Fernandes, SM, Fedak, PWM, Girdauskas, E, Delgado, V, Abbara, S, Lansac, E, Prakash, SK, Bissell, MM, Popescu, BA, Hope, MD, Sitges, M, Thourani, VH, Pibarot, P, Chandrasekaran, K, Lancellotti, P, Borger, MA, Forrest, JK, Webb, J, Milewicz, DM, Makkar, R, Leon, MB, Sanders, SP, Markl, M, Ferrari, VA, Roberts, WC, Song, JK, Blanke, P, White, CS, Siu, S, Svensson, LG, Braverman, AC, Bavaria, J, Sundt, TM, El Khoury, G, De Paulis, R, Enriquez-Sarano, M, Bax, JJ, Otto, CM & Schäfers, HJ 2021, 'International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes', Annals of Thoracic Surgery, vol. 112, no. 3, pp. e203-e235. https://doi.org/10.1016/j.athoracsur.2020.08.119

International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes. / Michelena, Hector I.; Della Corte, Alessandro; Evangelista, Arturo et al.
In: Annals of Thoracic Surgery, Vol. 112, No. 3, 09.2021, p. e203-e235.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes

AU - Michelena, Hector I.

AU - Della Corte, Alessandro

AU - Evangelista, Arturo

AU - Maleszewski, Joseph J.

AU - Edwards, William D.

AU - Roman, Mary J.

AU - Devereux, Richard B.

AU - Fernández, Borja

AU - Asch, Federico M.

AU - Barker, Alex J.

AU - Sierra-Galan, Lilia M.

AU - De Kerchove, Laurent

AU - Fernandes, Susan M.

AU - Fedak, Paul W.M.

AU - Girdauskas, Evaldas

AU - Delgado, Victoria

AU - Abbara, Suhny

AU - Lansac, Emmanuel

AU - Prakash, Siddharth K.

AU - Bissell, Malenka M.

AU - Popescu, Bogdan A.

AU - Hope, Michael D.

AU - Sitges, Marta

AU - Thourani, Vinod H.

AU - Pibarot, Phillippe

AU - Chandrasekaran, Krishnaswamy

AU - Lancellotti, Patrizio

AU - Borger, Michael A.

AU - Forrest, John K.

AU - Webb, John

AU - Milewicz, Dianna M.

AU - Makkar, Raj

AU - Leon, Martin B.

AU - Sanders, Stephen P.

AU - Markl, Michael

AU - Ferrari, Victor A.

AU - Roberts, William C.

AU - Song, Jae Kwan

AU - Blanke, Philipp

AU - White, Charles S.

AU - Siu, Samuel

AU - Svensson, Lars G.

AU - Braverman, Alan C.

AU - Bavaria, Joseph

AU - Sundt, Thoralf M.

AU - El Khoury, Gebrine

AU - De Paulis, Ruggero

AU - Enriquez-Sarano, Maurice

AU - Bax, Jeroen J.

AU - Otto, Catherine M.

AU - Schäfers, Hans Joachim

N1 - Funding Information: The authors wish to thank Carl Clingman, Senior Medical Illustrator, Biomedical & Scientific Visualization, Mayo Clinic and Pavel Zacek, Department of Cardiac Surgery, Charles University Hospital, Hradec Kralove, Czech Republic, for their illustrations. Conflict of interest: Victoria Delgado: discloses a financial relationship with Abbott Vascular, Edwards Lifesciences, GE Healthcare, MSD, Medtronic, and Novartis. Emmanuel Lansac: patent Extra Aortic ring annuloplasty device with Coroneo Inc. Phillippe Pibarot: funding from Edwards Lifesciences and Medtronic for echocardiography core laboratory services with no personal compensation. Michael A. Borger: discloses a financial relationship with Edwards Lifesciences, Medtronic, Abbott, and CryoLife. John K. Forrest: grant support and consultant to: Edwards Lifesciences, Medtronic Inc. John Webb: consultant to: Edwards Lifesciences, Abbott, Boston Scientific. Martin B. Leon: institutional clinical research grants from Abbott, BSC, Edwards and Medtronic. Michael Markl: research support—Siemens Healthineers, Research Grant—Circle Cardiovascular Imaging, Consulting—Circle Cardiovascular Imaging, Research Grant—CryoLife Inc. Victor A. Ferrari: Senior Advisory Board, Journal of Cardiovascular Magnetic Resonance. Philipp Blanke: consultant for Edwards Lifesciences and Circle Cardiovascular Imaging; and provides CT core lab services for Edwards Lifesciences, Medtronic, Neovasc, and Tendyne Holdings, for which he receives no direct compensation. Ruggero De Paulis: patent on aortic root graft with Terumo Aortic. Consultant for Edwards Lifesciences, Medtronic, and Terumo Aortic. Maurice Enriquez-Sarano: consulting fees from Edwards LLC, CryoLife, and ChemImage. The Department of Cardiology of the LUMC received unrestricted research grants from Abbott Vascular, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare, and Medtronic. The other authors report no conflict of interest. Funding Information: Conflict of interest: Victoria Delgado: discloses a financial relationship with Abbott Vascular, Edwards Lifesciences, GE Healthcare, MSD, Medtronic, and Novartis. Emmanuel Lansac: patent Extra Aortic ring annuloplasty device with Coroneo Inc. Phillippe Pibarot: funding from Edwards Lifesciences and Medtronic for echocardiography core laboratory services with no personal compensation. Michael A. Borger: discloses a financial relationship with Edwards Lifesciences, Medtronic, Abbott, and CryoLife. John K. Forrest: grant support and consultant to: Edwards Lifesciences, Medtronic Inc. John Webb: consultant to: Edwards Lifesciences, Abbott, Boston Scientific. Martin B. Leon: institutional clinical research grants from Abbott, BSC, Edwards and Medtronic. Michael Markl: research support—Siemens Healthineers, Research Grant—Circle Cardiovascular Imaging, Consulting—Circle Cardiovascular Imaging, Research Grant—CryoLife Inc. Victor A. Ferrari: Senior Advisory Board, Journal of Cardiovascular Magnetic Resonance. Philipp Blanke: consultant for Edwards Lifesciences and Circle Cardiovascular Imaging; and provides CT core lab services for Edwards Lifesciences, Medtronic, Neovasc, and Tendyne Holdings, for which he receives no direct compensation. Ruggero De Paulis: patent on aortic root graft with Terumo Aortic. Consultant for Edwards Lifesciences, Medtronic, and Terumo Aortic. Maurice Enriquez-Sarano: consulting fees from Edwards LLC, CryoLife, and ChemImage. The Department of Cardiology of the LUMC received unrestricted research grants from Abbott Vascular, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare, and Medtronic. The other authors report no conflict of interest. Publisher Copyright: © 2021 Jointly between The Society of Thoracic Surgeons, the American Association for Thoracic Surgery, the European Association for Cardio-Thoracic Surgery, and the Radiological Society of North America

PY - 2021/9

Y1 - 2021/9

N2 - This International Consensus Classification and Nomenclature for the congenital bicuspid aortic valve condition recognizes 3 types of bicuspid valves: 1. The fused type (right-left cusp fusion, right-non-coronary cusp fusion and left-non-coronary cusp fusion phenotypes); 2. The 2-sinus type (latero-lateral and antero-posterior phenotypes); and 3. The partial-fusion (forme fruste) type. The presence of raphe and the symmetry of the fused type phenotypes are critical aspects to describe. The International Consensus also recognizes 3 types of bicuspid valve-associated aortopathy: 1. The ascending phenotype; 2. The root phenotype; and 3. Extended phenotypes.

AB - This International Consensus Classification and Nomenclature for the congenital bicuspid aortic valve condition recognizes 3 types of bicuspid valves: 1. The fused type (right-left cusp fusion, right-non-coronary cusp fusion and left-non-coronary cusp fusion phenotypes); 2. The 2-sinus type (latero-lateral and antero-posterior phenotypes); and 3. The partial-fusion (forme fruste) type. The presence of raphe and the symmetry of the fused type phenotypes are critical aspects to describe. The International Consensus also recognizes 3 types of bicuspid valve-associated aortopathy: 1. The ascending phenotype; 2. The root phenotype; and 3. Extended phenotypes.

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JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

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Michelena HI, Della Corte A, Evangelista A, Maleszewski JJ, Edwards WD, Roman MJ et al. International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes. Annals of Thoracic Surgery. 2021 Sep;112(3):e203-e235. doi: 10.1016/j.athoracsur.2020.08.119

International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve and Its Aortopathy, for Clinical, Surgical, Interventional and Research Purposes

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