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Published on: May 10, 2021
A clinicopathological study on aortic valves in children
Ping Huang1, Hongwei Wang, Zhenlu Zhang
1Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. huangping999@126.com
Summary
In children, aortic valve disease is most often aortic insufficiency (AI), primarily caused by congenital malformations or rheumatic disease. Congenital bicuspid aortic valves in children typically present as AI, differing from adult presentations.
Area of Science:
- Cardiology
- Pediatric Pathology
- Clinical Medicine
Background:
- Aortic valve disease (AVD) in children presents unique clinicopathological characteristics.
- Understanding the etiology and presentation of pediatric AVD is crucial for effective management.
Purpose of the Study:
- To investigate the clinicopathological characteristics of aortic valve disease in pediatric patients.
- To determine the common etiologies and types of AVD in children.
Main Methods:
- Macroscopic and microscopic examination of 70 surgically excised native aortic valves from children aged 6-18 years.
- Review of patient medical records, including preoperative echocardiography, intraoperative assessment, and postoperative pathology.
- Classification of AVD into aortic stenosis (AS), aortic insufficiency (AI), and mixed AS-AI based on clinical and pathological findings.
Main Results:
- Aortic insufficiency (AI) was the predominant form (85.71%), followed by AS and AS-AI (7.14% each).
- Congenital aortic valve malformation (45.71%) and rheumatic disease (40%) were the most frequent causes.
- Congenital bicuspid aortic valves in children commonly presented as AI, with myxomatous changes, and less fibrosis/calcification compared to adults.
Conclusions:
- Congenital malformation and rheumatic disease are the leading causes of pediatric AVD.
- AI is the most common type of AVD in children, often linked to congenital bicuspid valves or rheumatic heart disease.
- Integrated clinicopathological evaluation is essential for accurate etiological diagnosis of pediatric AVD.
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