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Drs. Koenraadt and Grewal contributed equally to this work.
The clinical course of bicuspid aortic valves (BAVs) is variable. Data on predictors of aortopathy and valvular dysfunction mainly focus on valve morphology.
To determine whether the presence and extent of the raphe (fusion site of valve leaflets) is associated with the degree of aortopathy and valvular dysfunction in patients with isolated BAV and associated aortic coarctation (CoA).
Valve morphology and aortic dimensions of 255 BAV patients were evaluated retrospectively by echocardiography.
BAVs with a complete raphe had a significantly higher prevalence of valve dysfunction (especially aortic regurgitation) than BAVs with incomplete raphes (82.9 vs. 66.7 %, p = 0.01). Type 1A BAVs (fusion of right and left coronary leaflets) and complete raphe had larger aortic sinus diameters compared with the rest of the population (37.74 vs. 36.01, p = 0.031). Patients with CoA and type 1A BAV had significantly less valve regurgitation (13.6 vs. 55.8 %, p < 0.001) and smaller diameters of the ascending aorta (33.7 vs. 37.8 mm, p < 0.001) and aortic arch (25.8 vs. 30.2 mm, p < 0.001) than patients with isolated BAV.
Type 1A BAV with complete raphe is associated with more aortic regurgitation and root dilatation. The majority of CoA patients have incomplete raphes, associated with smaller aortic root diameters and less valve regurgitation.
Williams DS. Bicuspid aortic valve. J Insur Med. 2006;38:72–4. PubMed
Duran AC, Frescura C, Sans-Coma V, Angelini A, Basso C, Thiene G. Bicuspid aortic valves in hearts with other congenital heart disease. J Heart Valve Dis. 1995;4:581–90. PubMed
Kim JS, Ko SM, Chee HK, Shin JK, Song MG, Shin HJ. Relationship between bicuspid aortic valve phenotype, valvular function, and ascending aortic dimensions. J Heart Valve Dis. 2014;23:406–13. PubMed
Jackson V, Petrini J, Caidahl K, et al. Bicuspid aortic valve leaflet morphology in relation to aortic root morphology: a study of 300 patients undergoing open-heart surgery. Eur J Cardiothorac Surg. 2011;40:e118–24. PubMed
- The extent of the raphe in bicuspid aortic valves is associated with aortic regurgitation and aortic root dilatation
W. M. C. Koenraadt
O. Y. Gaidoukevitch
M. C. DeRuiter
A. C. Gittenberger-de Groot
M. M. Bartelings
E. R. Holman
R. J. M. Klautz
M. J. Schalij
M. R. M. Jongbloed
- Bohn Stafleu van Loghum