ライフサイエンスコーパス: valve

1 he balloon-expandable Edwards Sapien 3 (ES3) valve.

2 ation balloon-expandable transcatheter heart valve.

3 levels of the ovipositor and its individual valves.

4 nses that remodel cardiac cushions to mature valves.

5 ymphatic vascular systems, and the lymphatic valves.

6 ct into lymphatic tributaries with defective valves.

7 be inserted without reciprocal motion of the valves.

8 irst and second generations of transcatheter valves.

9 of the observed artifacts with native aortic valves.

10 aorta samples from other 10 tricuspid aortic valve, 10 BAVnon-dil, and 10 BAVdil patients.

11 High-intensity aortic valve (18)F-fluoride uptake was observed in all patients

12 was greater in mechanical than in biological valves (4.0 [2.4-8.0] versus 3.3 [2.1-6.1]; P=0.01) and

13 46) and had a better knowledge of prosthetic valves (85% versus 68%; P=0.004).

14 olving premature calcification of the aortic valve, a phenotype that closely mimics human disease cau

15 ngoing bladder dysfunction in patients after valve ablation remains a cause of long-term morbidity.

16 Second Valve Academic Research Consortium (VARC-2) life-threate

17 Adverse events are defined with Valve Academic Research Consortium 2 criteria and adjudi

18 iV and ViR were compared according to Mitral Valve Academic Research Consortium criteria.

19 30 days after implantation using the Mitral Valve Academic Research Consortium definitions.

20 mittee adjudicated safety endpoints based on Valve Academic Research Consortium-2 definitions.

21 Valve Academic Research Consortium-2 early safety end po

22 A novel combination of a fast gas-sampling valve and a soot particle aerosol mass spectrometer (SP-

23 so associated with increased rates of aortic valve and aortic surgery.

24 significantly decreased in tricuspid aortic valve and BAVnon-dil patients versus healthy subjects.

25 In patients with bicuspid aortic valve and dilated proximal ascending aorta, we sought to

26 ed in the registry, 1592 received a SAPIEN 3 valve and had assessment of PVR.

27 rostheses increased substantially for aortic-valve and mitral-valve replacement, from 11.5% to 51.6%

28 move toward bioengineered patches, conduits, valves, and even whole organs.

29 s, significant injuries to the aorta, aortic valve annulus, and left ventricle require open surgical

30 or complications involving the aorta, aortic valve annulus, and left ventricle.

31 acement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of

32 Posterior urethral valves are associated with considerable mortality; fetal

33 The valves are fabricated from electrically conductive, insu

34 rative data on different transcatheter heart valves are missing.

35 Severe PAS was defined as aortic valve area <0.8 cm(2), mean aortic valve gradient >/=40

36 (AS) most often presents with reduced aortic valve area (<1 cm(2)), normal stroke volume index (>/=35

37 ven consecutive patients with reduced aortic valve area and normal stroke volume index undergoing AVR

38 Aortic valve area increased to >/=1.0 cm(2) in 6 LF (24%) and 4

39 with moderate-severe asymptomatic AS (aortic valve area, 0.5+/-0.1 cm(2)/m(2); peak gradient, 53+/-19

40 The duration of the aortic valve artifact was 39+/-8 ms with amplitude of 0.12+/-0.

41 Aortic valve artifact was observed while mapping within the cor

42 Most patients received bioprosthetic valves (AVR+ARE: 73.4% versus AVR: 73.3%, P=0.98) and al

43 TIONALE: The pathogenesis of bicuspid aortic valve (BAV)-associated aortopathy is poorly understood,

44 (Registry of Aortic Valve Bioprostheses Established by Catheter [FRANCE TAVI

45 ing SB length, and the presence of ileocecal valve, both estimates of maximal SB dilatation remained

46 e/severe mitral stenosis or mechanical heart valves, but variably included patients with other VHD an

47 Median aortic valve calcification (1973 [1124-3490] Agatston units) an

48 Aortic valve calcification density correlated better with valve

49 adjustment for age, body mass index, aortic valve calcification density, and aortic annulus diameter

50 However, women present lower aortic valve calcification loads than men for the same AS hemod

51 ENTERA-EU Self-Expanding Transcatheter Heart Valve [CENTERA-2]; NCT02458560).

52 ventricular contraction ablation, an aortic valve closure artifact is observed in up to one third of

53 )F-fluoride PET/CT and PET/MRI of the aortic valve could improve PET quantitation and image quality.

54 s play an essential epigenetic role in heart valve development, but how they do so is not known.

55 ces and intrinsic cues to regulate lymphatic valve development.

56 mesenchymal cells, a critical step in heart valve development.

57 e was lower (P<0.001) and the mean tricuspid valve diameter z score was higher in fetuses with CoA th

58 Mean mitral valve diameter z score was lower (P<0.001) and the mean

59 ncreased repair rates of degenerative mitral valve disease (adjusted odds ratio [OR]: 1.13 for every

60 In calcific aortic valve disease (CAVD), activated T lymphocytes localize w

61 interventions to treat mitral and tricuspid valve disease are becoming increasingly available becaus

62 UK patients with no known cardiovascular or valve disease at baseline were included in this cohort s

63 sues from the patients with rheumatic mitral valve disease in either sinus rhythm or persistent AF we

64 RATIONALE: Aortic valve disease is a cell-mediated process without effecti

65 e incidence of clinically significant mitral valve disease requires further study.

66 V, previous admission for heart failure, and valve disease) and non-cardiac variables (body-mass inde

67 ome persons, particularly those with cardiac valve disease, infection with C. burnetii can cause a li

68 isk factor for clinically significant mitral valve disease, suggesting a causal association.

69 ndidates targeting the progression of aortic valve disease.

70 tation, and in patients with bicuspid aortic valve disease.

71 context of both moderate and advanced aortic valve disease.

72 ice causes accelerated progression of aortic valve disease.

73 l haemodynamic consequences of severe aortic valve diseases (with preserved LV ejection fraction).

74 KEY POINTS: Severe aortic valve diseases are common cardiac abnormalities that are

75 haemodynamic cardiac consequences of aortic valve diseases in those with preserved LV ejection fract

76 per, we provide an overview of bioprosthetic valve durability, focusing on the definition, incidence,

77 caused by opening and closing of respiratory valves during air recirculation between the lungs and la

78 nscatheter and Surgical Aortic Bioprosthetic Valve Dysfunction With Multimodality Imaging and Its Tre

79 When presenting with moderate/severe aortic valve dysfunction, men had more frequent aortic regurgit

80 ontrolled trials of the Zephyr endobronchial valve (EBV) treatment have demonstrated benefit in sever

81 observation of a large superconducting spin-valve effect with a T c change 1 K in superconductor/ha

82 6.7+/-3.7 mm Hg, P<0.001) and an increase in valve effective orifice area (from 1.0+/-0.4 to 1.8+/-0.

83 odynamic measurements and calculation of the valve effective orifice area were performed at baseline,

84 0 cases of Mycobacterium chimaera prosthetic valve endocarditis and disseminated disease were notifie

85 2013, the proportion of patients with native-valve endocarditis decreased (from 74.5% to 68.4%; APC,

86 erpreting FDG PET/CT in suspected prosthetic valve endocarditis, with specific attention to uptake pa

87 o surgical AVR in the transcatheter valve-in-valve era.

88 risk patients, TAVR for bioprosthetic aortic valve failure is associated with relatively low mortalit

89 ting of maternal death, thromboembolism, and valve failure, and/or fetal spontaneous abortion, death,

90 using 0.1 M iron (iii) chloride, making the valve fairly easy to incorporate into point-of-care form

91 egory, younger age, and morphological mitral valve features were risk factors for an unfavorable outc

92 s, aimed to assess sex differences in aortic valve fibrocalcific remodeling.

93 At the early stages of zebrafish heart valve formation, we show that endocardial cells are conv

94 that endocardial cells are converging to the valve-forming area and that this behavior depends upon m

95 sulted in reduced proliferation of Prox1(hi) valve-forming cells.

96 a wide range of conduit sizes with preserved valve function and low incidence of stent fracture and e

97 Aortic valve function was divided into normal, regurgitation, o

98 BAV morphology and valve function were assessed; aortopathy configuration w

99 al bicuspid aortic valves, with worse aortic valve function, fibrosis, and calcification than those N

100 as aortic valve area <0.8 cm(2), mean aortic valve gradient >/=40 mm Hg, and dimensionless index <0.2

101 The mean aortic valve gradient was 8.5 +/- 5.6 mm Hg, and moderate or se

102 f more than 20 mm Hg and increases in aortic valve gradients of more than 10 mm Hg (12 [14%] of 88) t

103 th subclinical leaflet thrombosis had aortic valve gradients of more than 20 mm Hg and increases in a

104 Mean mitral valve gradients were similar between groups (6.4 +/- 2.3

105 Patients who received mechanical valves had a higher cumulative incidence of bleeding and

106 within failed bioprosthetic surgical aortic valves has shown that valve-in-valve (VIV) TAVR is a fea

107 adient acutely after transcatheter pulmonary valve implantation (39 versus 10 mm Hg; P<0.001).

108 irst matched comparison of THVs for valve-in-valve implantations, Portico and CoreValve demonstrated

109 Patients with sequential second Ahmed valves implanted in the same eye from 1994 to 2016 were

110 was successfully implanted in the tricuspid valve in 97% of the cases.

111 (MscL), acts as an osmoprotective emergency valve in bacteria by opening a large, water-filled pore

112 Implantation success (1 valve in the intended location) was 98.3%.

113 ecifically from the leaflets of intraluminal valves in collecting LVs.

114 esidual MR in the remaining 26 patients with valves in situ.

115 thetic surgical aortic valves has shown that valve-in-valve (VIV) TAVR is a feasible therapeutic opti

116 adjunct to surgical AVR in the transcatheter valve-in-valve era.

117 In this first matched comparison of THVs for valve-in-valve implantations, Portico and CoreValve demo

118 Portico- (n=54) and CoreValve- (n=108) based valve-in-valve procedures comprised the study population

119 Valve-in-valve procedures were performed in 365 patients

120 METHODS AND In cultured porcine valve interstitial cells, CNP inhibited pathological dif

121 elopment and integration of active, chemical valves into lateral flow devices, using a scalable, sing

122 The valve is a self-expanding, nitinol valve with bovine per

123 al acceleration of the blood jet through the valve is most significant (accounting for 99% of the tot

124 stheses specifically designed for the mitral valve is warranted.

125 a line connecting the origins of the mitral valve leaflets at end systole and end diastole.

126 to decipher relationships relevant to early valve lesion pathobiology.

127 Mitral regurgitation (MR) is a complex valve lesion that can pose significant management challe

128 PET indication, valve location, and type (biological/mechanical) and tim

129 onth outcomes of the Boston Scientific Lotus valve (Lotus) and the balloon-expandable Edwards Sapien

130 on of flow analysis techniques, i.e., lab-on-valve (LOV) and multisyringe flow injection analysis (MS

131 HV) is a low-profile, self-expanding nitinol valve made from bovine pericardial tissue that is 14-F c

132 oper lymphatic drainage, defective lymphatic valve maturation, and complete lethality.

133 epicardial or above versus below the aortic valve) may be considered (anatomic ablation).

134 AVR, with a decrease of -2.9 mm Hg in aortic valve mean gradient, an increase of 0.028 in Doppler vel

135 ined as TAVR in patients with known bicuspid valve, moderate aortic stenosis, severe mitral regurgita

136 alkylphenones and compared to a conventional valve-modulator employing sample loops.

137 hatic vessels, edema, defective lymphovenous valve morphogenesis, improper lymphatic drainage, defect

138 of TMVR in a cohort of patients with native valve MR who were at high risk for cardiac surgery.

139 CAVD valves (n = 52) dissected into noncalcified and calcifie

140 Even after relief of valve obstruction in patients with aortic stenosis, ther

141 rload is often characterized by the residual valve obstruction.

142 2FA is present in plaque found on the aortic valve of ApoE (-/-) mice.

143 containing DOC was loaded into the injection valve of the continuous flow manifold.

144 Currently, reliable valving on integrated microfluidic devices fabricated fr

145 to those proposed for humpback whales, where valve open/closure and vocal fold oscillation is passive

146 tween peak twisting and untwisting at mitral valve opening (%untwMVO) using speckle-tracking echocard

147 hose Npr2(+/-) with typical tricuspid aortic valves or all wild-type littermate controls.

148 No complicated injection, valving, or voltage changes were necessary to couple the

149 septal defect (P=0.12), and bicuspid aortic valve (P=0.14) did not carry an increased risk for this

150 13%) of 752 with thrombosis of transcatheter valves (p=0.001).

151 risk factor for higher fibrosis score in AS valves (P=0.003).

152 xists for circumferentially sutured surgical valve paravalvular leak (PVL) closure.

153 led in the Placement of Aortic Transcatheter Valves (PARTNER) 1 Trial with successful TAVR or surgica

154 II Trial: Placement of AoRTic TraNscathetER Valves [PARTNER II]; NCT01314313).

155 Furthermore, metoprolol reduced aortic valve peak -7 mm Hg (-13, 0; P=0.05) and mean -4 mm Hg (

156 Precise definition of the mitral valve plane (VP) during segmentation of the left ventric

157 the velocity distribution across the aortic valve plane.

158 l aortic valve replacement were optimized on valve positioning and reduction of residual aortic regur

159 (n=54) and CoreValve- (n=108) based valve-in-valve procedures comprised the study population with no

160 Valve-in-valve procedures were performed in 365 patients (96 init

161 rates of scoliosis, pectus excavatum, mitral valve prolapse, and mutations in the CFTR gene.

162 y mitral regurgitation (MR) caused by mitral valve prolapse.

163 nsapical delivery of a self-expanding mitral valve prosthesis and were examined in a prospective regi

164 The implantation of Ahmed valve proved to be effective treatment for these patient

165 ces of aortic valve stenosis (AS) and aortic valve regurgitation (AR).

166 VR in lower-risk patients with severe mitral valve regurgitation (Evaluation of the Safety and Perfor

167 Secondary mitral valve regurgitation (MR) remains a challenging problem i

168 e development of clinically important mitral valve regurgitation and mitral valve stenosis.

169 no deaths, strokes, bleeding, tamponade, or valve reintervention.

170 tality, better long-term survival, and fewer valve-related complications compared with MV replacement

171 concomitant procedures other than tricuspid valve repair at the time of LVAD.

172 nstrate that commercial transcatheter mitral valve repair is being performed in the United States wit

173 onary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of

174 f surgeon case volume on degenerative mitral valve repair rates and outcomes.

175 egurgitation (MR) were treated with a mitral valve repair system (MVRS) via small left thoracotomy.

176 hich patients underwent transcatheter mitral valve repair using the Edwards PASCAL TMVr system.

177 mmercially treated with transcatheter mitral valve repair were analyzed.

178 ial fibrillation ablation or surgical mitral valve repair).

179 Transcatheter mitral valve repair, particularly edge-to-edge leaflet repair,

180 aortic root enlargement (ARE) during aortic valve replacement (AVR) allows for larger prosthesis imp

181 Pulmonary valve replacement (PVR) in patients with repaired tetral

182 Aortic valve replacement (surgical or catheter based) was perfo

183 c stenosis undergoing a transcatheter aortic valve replacement (TAVR) and the effect of TAVR on subse

184 -day readmissions after transcatheter aortic valve replacement (TAVR) are limited.

185 With the approval of transcatheter aortic valve replacement (TAVR) for patients with severe sympto

186 ials support the use of transcatheter aortic valve replacement (TAVR) for the treatment of aortic ste

187 Transcatheter aortic valve replacement (TAVR) has become a well-accepted opti

188 luating the outcomes of transcatheter aortic valve replacement (TAVR) in diabetic patients are limite

189 safety and efficacy of transcatheter aortic valve replacement (TAVR) in patients with pure native ao

190 Transcatheter aortic valve replacement (TAVR) is standard therapy for patient

191 The introduction of transcatheter aortic valve replacement (TAVR) led to renewed interest in ball

192 cal complications after transcatheter aortic valve replacement (TAVR) may be reduced with transcathet

193 performance outcomes of transcatheter aortic valve replacement (TAVR) with a next-generation, self-ex

194 sed mortality following transcatheter aortic valve replacement (TAVR) with first and second generatio

195 sedation is used during transcatheter aortic valve replacement (TAVR) with limited evidence as to the

196 Early experience with transcatheter aortic valve replacement (TAVR) within failed bioprosthetic sur

197 ed data exist regarding transcatheter mitral valve replacement (TMVR) for patients with failed mitral

198 More recently, transcatheter mitral valve replacement (TMVR) has emerged as a potential ther

199 Transcatheter mitral valve replacement (TMVR) is a potential therapy for pati

200 Transcatheter mitral valve replacement (TMVR) may be an option for selected p

201 (Cerebral Protection in Transcatheter Aortic Valve Replacement [SENTINEL]; NCT02214277).

202 replacement, from 11.5% to 51.6% for aortic-valve replacement and from 16.8% to 53.7% for mitral-val

203 a common finding after transcatheter aortic valve replacement and often result in permanent pacemake

204 ement (TMVR) for patients with failed mitral valve replacement and repair.

205 patients who underwent transcatheter aortic valve replacement between the years 2011 and 2014.

206 distribution including transcatheter aortic valve replacement eligibility in low-risk patients acros

207 Evolut R, and SAPIEN 3 transcatheter aortic valve replacement enrolled in the RESOLVE study (Assessm

208 Furthermore, aortic valve replacement event rates were significantly higher

209 lyzed 78 patients undergoing surgical aortic valve replacement for severe aortic stenosis between 201

210 Transcatheter aortic valve replacement has become the procedure of choice for

211 In recent years, use of transcatheter aortic valve replacement has expanded to include patients at in

212 ould postpone or prevent the need for aortic valve replacement in patients with asymptomatic AS.

213 Surgical aortic valve replacement in patients with small annular dimensi

214 ive patients undergoing transcatheter aortic valve replacement in Switzerland between February 2011 a

215 Transcatheter aortic valve replacement might be a good alternative; however,

216 rts of patients who underwent primary aortic-valve replacement or mitral-valve replacement with a mec

217 However, the transcatheter aortic valve replacement patient presents a unique challenge as

218 of the Twelve Intrepid Transcatheter Mitral Valve Replacement System in High Risk Patients with Seve

219 nd (2) to a theoretical transcatheter aortic valve replacement valve size.

220 Implanted surgical aortic valve replacement valves were smaller relative to MDCT-b

221 w generation devices for transfemoral aortic valve replacement were optimized on valve positioning an

222 t primary aortic-valve replacement or mitral-valve replacement with a mechanical or biologic prosthes

223 Transfemoral aortic valve replacement with the ES3 and the Lotus were associ

224 ng (QRS fragmentation and previous pulmonary valve replacement) (+2.7%; 95% confidence interval, +0.1

225 ed substantially for aortic-valve and mitral-valve replacement, from 11.5% to 51.6% for aortic-valve

226 After aortic valve replacement, left ventricular afterload is often c

227 Among patients who underwent aortic-valve replacement, receipt of a biologic prosthesis was

228 who may have undergone transcatheter aortic valve replacement, we conducted a subgroup analysis of p

229 d current guidelines recommend prompt aortic valve replacement.

230 ted tomography within 3 months before aortic valve replacement.

231 n patients eligible for transcatheter aortic valve replacement.

232 nferiority of TAVR as compared with surgical valve replacement.

233 ity did not differ before and 3 months after valve replacement.

234 high or extreme risk for conventional mitral valve replacement.

235 placement and from 16.8% to 53.7% for mitral-valve replacement.

236 Mortality is greatest in patients undergoing valve replacement.

237 Transcatheter aortic valve replacement.

238 ial for guiding the optimal timing of aortic valve replacement.

239 nths in patients undergoing attempted aortic-valve replacement.

240 k patients eligible for transcatheter aortic valve replacement.

241 patients had undergone transcatheter aortic valve replacement.

242 fraction recovery post-transcatheter aortic valve replacement.

243 propriate valve sizing is critical in aortic valve replacement.

244 high-pressure balloon positioned across the valve ring during rapid ventricular pacing.

245 TVs with INPs provide a much needed reliable valving scheme for rigid plastic devices with low comple

246 s included patient knowledge, involvement in valve selection, anxiety and depression, (valve-specific

247 al part of the ovipositor by protracting one valve set with respect to the other.

248 which was then (1) compared to the implanted valve size and (2) to a theoretical transcatheter aortic

249 sis for assignment to a theoretical surgical valve size, which was then (1) compared to the implanted

250 tical transcatheter aortic valve replacement valve size.

251 Appropriate valve sizing is critical in aortic valve replacement.

252 We hypothesized that direct intraoperative valve sizing results in smaller aortic annular diameters

253 in valve selection, anxiety and depression, (valve-specific) quality of life, and regret.

254 haemodynamic cardiac consequences of aortic valve stenosis (AS) and aortic valve regurgitation (AR).

255 asurements were performed in HOCM and aortic valve stenosis patients 4 months after surgery.

256 rdiomyopathy (HOCM), 10 patients with aortic valve stenosis, and 14 healthy individuals using [(11)C]

257 In contrast to patients with aortic valve stenosis, MEE was not improved in patients with HO

258 ortant mitral valve regurgitation and mitral valve stenosis.

259 incidence of Melody transcatheter pulmonary valve stent fracture (3.4%) and infectious endocarditis

260 ariably included patients with other VHD and valve surgeries.

261 nderwent coronary artery bypass grafting and valve surgery between January 2000 and December 2005, 97

262 Valve surgery quality improvement endeavors should focus

263 ther died or developed indication for mitral valve surgery.

264 arly Feasibility Study of the Tendyne Mitral Valve System [Global Feasibility Study]; NCT02321514).

265 The GC, equipped with a gas inlet and a valve that transfers the H2S to a thermal conductivity d

266 y consists of three longitudinally connected valves that can slide along each other.

267 per describes electrically-activated fluidic valves that operate based on electrowetting through text

268 Furthermore, radiation can damage the heart valves, the conduction system, and pericardium, which ma

269 95 hospitals submitting to the Transcatheter Valve Therapy Registry from 2011 through 2015.

270 e Society of Thoracic Surgeons/Transcatheter Valve Therapy Registry linked to Medicare claims data, w

271 American College of Cardiology Transcatheter Valve Therapy Registry on patients commercially treated

272 American College of Cardiology Transcatheter Valve Therapy Registry was used to characterize the anes

273 ted States are included in the Transcatheter Valve Therapy Registry.

274 in studies evaluating leaflet immobility and valve thrombosis.

275 The CENTERA transcatheter heart valve (THV) is a low-profile, self-expanding nitinol val

276 neration, self-expanding transcatheter heart valve (THV) system in patients with severe symptomatic a

277 Transcatheter heart valve (THV) thrombosis has been increasingly reported.

278 nic device leads to interfere with tricuspid valve (TV) function has gained increasing recognition as

279 on (TR) with a structurally normal tricuspid valve (TV) may occur secondary to chronic atrial fibrill

280 e-pass spray chamber, and a rotary injection valve, used as an online interface between the microextr

281 stimate the peak pressure drop at the aortic valve using 3-dimensional cardiovascular magnetic resona

282 five (4%) of 138 with thrombosis of surgical valves versus 101 (13%) of 752 with thrombosis of transc

283 rgical aortic valves has shown that valve-in-valve (VIV) TAVR is a feasible therapeutic option with a

284 Venous valves (VVs) prevent venous hypertension and ulceration.

285 The valve was constructed from an electrically conductive po

286 The practical utility of the valve was demonstrated by performing a Lowry protein ass

287 ploying two-beam refraction and one solenoid valve was developed and found to successfully generate d

288 TMVR with the valve was feasible in a study group at high or extreme r

289 The tricuspid valve was virtually ignored for a long time in the past.

290 n (1973 [1124-3490] Agatston units) and mean valve weight (2.36+/-0.99 g) were lower in women compare

291 calcification density correlated better with valve weight in men (r(2)=0.57; P<0.0001) than in women

292 Implanted surgical aortic valve replacement valves were smaller relative to MDCT-based sizing in 41%

293 Explanted stenotic tricuspid aortic valves were weighed, and fibrosis degree was determined.

294 regulates the formation of both lymphovenous valves, which maintain the separation of the blood and l

295 wn lines of TpSAP1 and 3 displayed malformed valves; which confirmed their roles in frustule morphoge

296 R I trial (Placement of Aortic Transcatheter Valve) who had systolic blood pressure (SBP) and an echo

297 itionally, 4 patients with mechanical aortic valves, who underwent scar-related ventricular tachycard

298 The valve is a self-expanding, nitinol valve with bovine pericardial leaflets that is placed us

299 SAPIEN 3 valves with leaflet thrombosis were on average 10% furth

300 gous for Npr2 had congenital bicuspid aortic valves, with worse aortic valve function, fibrosis, and