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Clefted bicuspid aortic valve.

Daniela Mancuso1, Cristina Basso, Paolo Cardaioli

  • 1Institute of Pathology, University of Padua Medical School, Padua, Italy.

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
|July 26, 2002
PubMed
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A bicuspid aortic valve was unexpectedly discovered during surgery in a 67-year-old man undergoing aortic valve replacement. Preoperative imaging missed this congenital heart anomaly, highlighting diagnostic challenges.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pathology

Background:

  • Bicuspid aortic valve (BAV) is a common congenital heart defect.
  • BAV can lead to aortic stenosis and regurgitation, often requiring surgical intervention.
  • Accurate preoperative diagnosis is crucial for effective management.

Observation:

  • A 67-year-old male presented for aortic valve replacement due to severe aortic stenosis and moderate aortic regurgitation.
  • Preoperative echocardiography and angiocardiography did not identify the aortic valve as bicuspid.
  • The bicuspid nature of the valve was an incidental finding during surgical pathology examination.

Findings:

  • The aortic valve exhibited an unusual "cleft-like" appearance of the ventral leaflet.
  • This anomaly resulted from two conjoined cusps and a fenestrated rudimental raphe.

Related Experiment Videos

  • The specific morphology contributed to the failure of non-invasive imaging to detect the bicuspid valve.

    • Implications:

    • This case underscores the limitations of preoperative imaging in diagnosing atypical bicuspid aortic valve morphologies.
    • It highlights the importance of surgical pathology in confirming cardiac diagnoses.
    • Improved awareness of rare BAV presentations may enhance diagnostic accuracy in clinical practice.