Creating a Climate of Hope, an Atmosphere of Caring, and Information for All
Honoring a Pioneer
Dr. M. E. Abbott
Source: Museum Regional
Dr. M. E. Abbott devoted
much of her work to
congenital heart disease,
including bicuspid aortic
Honoring the Work of Dr. M. E. Abbott
Like most families, we had never heard of a bicuspid aortic valve.
When I was told my husband was born with BAV,
and years later told he had an aneurysm of the aorta above his heart,
I thought I must have married a man with a very rare condition.
It was surprising to me to learn that BAV was a common, well-known heart defect, identified
long ago (drawn by Leonardo da Vinci). I wondered why BAV was not more visible to the
public, since it is the most common heart defect present at birth.
We were told when his BAV was replaced, that my husband was "fixed", implying there was
nothing else to be concerned about. Later, when my husband was diagnosed with an
ascending aortic aneurysm, we were shaken. No longer could we believe that he was "fixed"
for life. And we wondered why no one had warned us, no one had told us he was at risk from a
bulging aorta. The bulge had already been there at the time of his valve surgery, but we were
never told. It had grown silently, without our knowledge.
The story of BAV in the medical literature includes a paper from 1928 by Abbott. For some
time, I wondered who Dr. Abbott was. Today, I have this entire paper from 1928, as well as Dr.
Abbott's Atlas of Congenital Heart Disease, in my possession. They are rich treasures, written
by this woman of amazing genius, who was an extraordinary, gifted physician.
Dr. Maude Abbott understood and published something very important in 1928 - something just
beginning to dawn on medicine today:
"The presence of a bicuspid aortic valve appears to indicate, at least in a portion of the cases
in which it occurs, a tendency to spontaneous rupture of the aorta, which hangs always, like a
sword of Damocles, above the unsuspecting subjects of this type of coarctation.... it seems
probable that the thinning, which is not infrequently seen in the wall of the ascending
aorta in these cases, may also be of congenital origin and due to the same arrest of
development that lead to an incomplete evolution of the endocardial cushions destined to
become the aortic cusps. That such a thinned area would yield the more readily to form a
dissecting aneurysm, with later rupture under the increased pressure that exists in the upper
body in adult coarctation, would appear to be self-evident. Extension of such a congenital
weakening of the media to the whole arterial system might similarly explain the
coincidence of cerebral hemorrhage and such a process might even have a part in the
peculiar changes at the area of coarctation itself."(from Abbott: Coarctation of the Aorta,
American Heart Journal, Volume 3, 1928) (see The Natural and Modified History of Congenital
Today, Dr. Abbott speaks across the decades through her published work. Her meticulously
documented study of her own cases and that of others sheds great light upon those with BAV
and associated vascular weakness. Having cared for these patients in life and examined
through autopsy their bodies after death, she understood a great deal through this
incontrovertible evidence about the nature of BAV and TAD.
From her writing, we can conclude that if still with us today, she would have understood what
my family, and other BAV families everywhere, have experienced. She would not have been
surprised by the aneurysm of my husband's ascending aorta, nor by Carrie Mettler's brain
aneurysm. BAV should be a red flag for these things, but they were shocks to us.
Tragically, the technology was not available in Dr. Abbott's day to help those with BAV/TAD
very much. Carefully studied, compassionately cared for, the patients died. No blood pressure
medicine, no antibiotics, no echocardiogram, MRI, or CT, no heart lung machine, no valve
replacement - the current era's wonders were not yet available.
Dr. Abbot's wisdom remains with us, as relevant now as when she first published her work.
It is our privilege to highlight it's importance today.
Dr. Maude Abbott has been called the "Canadian Queen of Cardiology". In 2013, sixty-three
years after after her death, we honor her as our "Queen of BAV Hearts".
Together let us
knowledge and advancements in medicine,
and let us support the pioneering physicians
who help us today,
creating a climate of hope.
- Arlys Velebir, Bicuspid Aortic Foundation President
Poster on BAV by Dr.
Maude Abbott, part of
her large collection of
work on congenital
heart disease displayed
in 1932 at the Centenary
Achives De Montreal,