Association of Mechanical Properties and Collagen Content With Valve Morphology in Ascending Thoracic Aortic Aneurysmal Tissue

Bicuspid aortic valve (BAV) is the most common congenital heart malformation occurring in 1–2% of the population with a high rate of morbidity [1]. There is a significantly higher rate of dilation of the aortic root in adults with a BAV when compared to the normal population and this condition is often associated with ascending thoracic aortic aneurysm (ATAA). ATAA is characterized as an enlargement of the aorta to twice its normal diameter. If left untreated, ATAA can lead to aortic dissection or rupture. Therefore, ATAA is recommended for prophylactic surgery when its diameter reaches about 5.5 cm. However, in certain high-risk cases, such as patients with BAV, ATAA may rupture when its diameter is less than 5.5 cm. Since ATAA dissection and rupture are biomechanical phenomena, better mechanical models are needed to more accurately predict these events over the predictive capability of diameter alone.