Dear colleagues,

Bicuspid aortic valve (BAV) disease is the most common anomaly of the human heart and presents with a wide spectrum of clinical phenotypes. Although the key pathophysiologic element of BAV is the lack of splitting of endocardial cushions forming aortic valve cusps during embryogenesis, the clinical presentation is extremely heterogeneous. The clinical diversity of BAV disease encompasses the whole spectrum between an adolescent with severe congenital aortic regurgitation and concomitant dilatation of the aortic root to severe calcific BAV stenosis with a mild dilatation of the tubular ascending aorta in a 75-year old severely comorbid patient referred for a transcatheter aortic valve replacement. Moreover, BAV is associated with a spectrum of concomitant anomalies including proximal aortopathy, aortic coarctation, atrial/ventricular septal defect or myxomatous mitral valve disease; all of which should be potentially addressed during the surgery. Therefore, the treatment of BAV disease requires an individualized, patient-tailored therapy approach.

These individualized, phenotype-specific treatment options of BAV disease will be covered by this specific Special Issue. All treatment options of aortic valve disease itself beginning with BAV repair, Ross surgery as well as aortic valve replacement for calcific aortic valve stenosis including catheter-based approaches will be addressed. In addition, the individualized therapy of bicuspid aortopathy according to specific clinical phenotypes (i.e., root dilatation, tubular ascending aorta disease and disease of the aortic arch, aortic isthmus) will be considered. An additional focus of this Special Issue will be on the concomitant treatment of co-existent cardiovascular manifestations of BAV disease, including mitral valve disease, coronary anomalies, and manifestations of multi-organ connective tissue disorders. Based on this observed clinical heterogeneity, our Special Issue is intended to reflect the patient-tailored and individualized treatment options of the whole spectrum of BAV disease.

Prof. Evaldas Girdauskas and Prof. Emmanuel Lansac

Guest Editors