Why the study?
Is there an association between bicuspid aortic valves or isolated aortic stenosis and left dominance of the coronary arterial system?
Is there an association between bicuspid aortic valves or isolated aortic stenosis and left dominance of the coronary arterial system?
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The study identifies a high incidence of left coronary dominance in patients with bicuspid aortic valves and isolated aortic stenosis, suggesting a developmental link and supporting the concept that progressive stenosis of a bicuspid aortic valve frequently causes isolated aortic stenosis in adults.
The dominance of the coronary arterial system was determined angiographically in 75 adult patients with isolated aortic stenosis with or without insufficiency, 25 adult patients with pure aortic insufficiency, 51 adult patients with combined aortic stenosis and mitral valve disease, and 44 children with bicuspid aortic valves. There was an unusually high incidence of left dominance in adults with isolated aortic stenosis (36%) and in children with bicuspid aortic valves (56.8%). These findings suggest the existence of a variant developmental complex consisting of a bicuspid aortic valve and reversal of dominance of the coronary arterial system. Furthermore, it adds support to the concept that progressive stenosis of a bicuspid aortic valve is frequently the etiology of isolated aortic stenosis in adults.
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Higgins et al. (1975) studied this question.
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