12-01-2016 | Original Article - Design Study Article | Uitgave 2/2016 Open Access
The extent of the raphe in bicuspid aortic valves is associated with aortic regurgitation and aortic root dilatation
- Tijdschrift:
- Netherlands Heart Journal > Uitgave 2/2016
Belangrijke opmerkingen
Drs. Koenraadt and Grewal contributed equally to this work.
Abstract
Background
The clinical course of bicuspid aortic valves (BAVs) is variable. Data on predictors of aortopathy and valvular dysfunction mainly focus on valve morphology.
Aim
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).
Methods
Valve morphology and aortic dimensions of 255 BAV patients were evaluated retrospectively by echocardiography.
Results
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.
Conclusions
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.