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Association of aortic dilation with regurgitant, stenotic and functionally normal bicuspid aortic valves

R T Hahn1, M J Roman, A H Mogtader

  • 1Department of Medicine, New York Hospital-Cornell Medical Center, New York.

Journal of the American College of Cardiology
|February 1, 1992
PubMed

Insights

Bicuspid aortic valve is linked to aortic root dilation, regardless of valve function. This suggests a shared developmental origin for both conditions in patients.

Area of Science:

  • Cardiology
  • Genetics
  • Developmental Biology

Background:

  • Bicuspid aortic valve (BAV) is a common congenital heart defect.
  • Aortic root dilation is frequently observed in patients with BAV.
  • The relationship between BAV, aortic dilation, and valvular hemodynamics requires clarification.

Purpose of the Study:

  • To investigate if aortic root dilation in BAV patients occurs independently of valvular hemodynamic abnormalities.
  • To determine the prevalence of aortic root enlargement across different BAV hemodynamic statuses.

Main Methods:

  • Two-dimensional echocardiography was used to measure aortic root dimensions in 83 adult BAV patients.
  • Patients were categorized by valvular function: normal, mild regurgitation, severe regurgitation, or stenosis.
  • Aortic root measurements were compared to age- and gender-matched controls.

Main Results:

  • All BAV hemodynamic subgroups exhibited significantly larger aortic root dimensions compared to controls.
  • Aortic root enlargement was prevalent across all measured levels (anulus, sinuses of Valsalva, supraaortic ridge, ascending aorta).
  • Enlargement prevalence varied by level, ranging from 9% to 79% across subgroups.

Conclusions:

  • Aortic root enlargement is highly prevalent in BAV patients and occurs irrespective of hemodynamic status or age.
  • These findings support a common developmental defect hypothesis for BAV and aortic root dilation.
  • BAV and aortic root dilation may share underlying genetic or developmental pathways.

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