Discussion & Conclusion
This case raises the question of whether the association between
bicuspid semilunar valve disease and vascular wall anomalies are more
genetic or hemodynamic. Even on the aortic side, despite the robust
association between bicuspid aortic valves and thoracic aortic
aneurysms, the mechanism still remains unclear. In our patient there was
no significant gradient across the bicuspid pulmonic valve, suggesting
that hemodynamics are not the primum mobile of this association.