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12-01-2016 | Original Article - Design Study Article | Uitgave 2/2016 Open Access

Netherlands Heart Journal 2/2016

The extent of the raphe in bicuspid aortic valves is associated with aortic regurgitation and aortic root dilatation

Netherlands Heart Journal > Uitgave 2/2016
W. M. C. Koenraadt, N. Grewal, 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
Belangrijke opmerkingen
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.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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