Key Points
- To investigate the pathological morphology of congenitally bicuspid aortic valves associated with pure valve regurgitation.
- Retrospective case series of 148 excised congenitally bicuspid aortic valves collected over five years at an academic hospital.
- Correlated valve morphology with patient age, sex, clinical history, preoperative hemodynamic function, and angiographic or echocardiographic aortic root dilatation.
- Classified valves into three morphologies: purely bicuspid (23%), bicuspid with a raphe (34%), and bicuspid with an indented free edge of the conjoined cusp (43%).
- Risk of regurgitation was significantly higher with conjoined cusp indentation (relative risk 4.95) and aortic root dilatation (relative risk 3.99).
- Patients requiring surgery for pure regurgitation (n=14) were significantly younger than those with combined stenosis and regurgitation (mean age 56.0 vs 64.7 years, p = 0.0008).
Structured PICO
PPopulation148 excised congenitally bicuspid aortic valves from patients at an academic hospital.
OOutcomeMorphological findings correlated with pure valve regurgitation (defined as grade 3-4/4 with a gradient less than 30 mm Hg).surrogate
Congenitally bicuspid aortic valves with a central indentation of the free edge of the conjoined cusp or aortic root dilatation are at significantly higher risk of developing pure aortic valve regurgitation.