Etiology of Aortic Valvular Disease

Abstract. On the basis of a clinical material comprising 222 patients with aortic valvular disease, of whom 161 had been subjected to aortic valvular surgery, the etiology of aortic stenosis and insufficiency has been considered. In this material 31% had congenital aortic stenosis. Previous rheumatic infection was found in 27% of the patients. In the majority of the remaining patients aortic stenosis is thought to develop on the basis of congenital bicuspid aortic valves, which is one of the most common congenital anomalies. Aortic insufficiency is most often combined with aortic stenosis and of the same etiology as aortic stenosis. In patients with pure aortic insufficiency, however, bacterial endocarditis is at the present time the most common cause of the insufficiency. Aortic dilatation with normal aortic valves was a common cause of aortic insufficiency. The dilatation was seen in rheumatoid spondylitis, following surgery for coarctation of the aorta, and in some cases was of unknown etiology. Syphilitic aortitis was seen in only one patient.