A Study to Identify Differences in Gene Expression in Patients With Bicuspid and Tricuspid Valve Disease

• Determine differences in the association between genetic expression profiles and aortic dilation in the two aortic valve disease groups. [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  Determine differences in the association between genetic expression profiles and aortic dilation (in cm) among: subjects with bicuspid aortic valves and subjects with tricuspid aortic valves with aortic stenosis.
• Determine the association between expression of inflammatory markers/impaired response to oxidative stress and stenotic aortic valve disease. [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  Determine differences between expression of inflammatory markers/impaired response to oxidative stress and stenotic aortic valve disease among: subjects with bicuspid aortic valves and subjects with tricuspid aortic valves with aortic stenosis.

For this study, blood and tissue samples will be collected in order to perform genetic testing to help researchers gather information about this disease and how and why it affects some patients more than others.

The cause of bicuspid aortic valve (BAV) and its associated co morbidities is unknown. There is, however, evidence supporting a genetic cause for the BAV, Pedigree analysis of familial clustering initially directed investigators to a genetic cause of BAV. Subsequent studies on BAV patients using linkage analysis have demonstrated high heritability.

Early identification of those patients with BAV disease who are at risk for ascending aneurysm formation and its complications may allow early intervention to prevent rupture, dissection and emergent cardiac surgery in at risk patients. Conversely, identification of those patients with BAVs not at risk for aortic aneurysm formation would delineate which patients do not need close follow up of aortic size or prophylactic ascending aortic replacement at time of aortic valve replacement.

Hospital facility

• 45 specimens collected from BAV patients
• 45 specimens collected from TAV patients
• 15 specimens will be collected from CABG patients

Inclusion Criteria:

• Patients > or = to 18 years of age
• Presenting with aortic stenosis and to undergo elective aortic valve replacement or repair with or without aortic aneurysm dilation repair
• Able to sign informed consent document

Exclusion Criteria:

• Patients unable to provide informed consent for any reason
• Patients with predominant aortic regurgitation valve disease
• Patients with other known connective tissue disorders (such as Marfan's Syndrome, Ehlers-Danlos Syndrome)