Metalloproteases (MMPs) have been hypothesized to participate in TAA development in the context of BAV, following the observation of a significant increase in MMP-2 levels associated with a reduction in TIMP-1 in BAV/TAA compared with TAA subjects, in the context of a normal tricuspid valve; a greater activity of MMP-2 and MMP-9 in aneurysms was associated with BAV, which could explain the higher prevalence of TAA in these patients [69,70]. Here, MMP2 is linked to aneurysm.