Measurement of Aortic Valve Coaptation and Effective Height Using Echocardiography in Patients with Ventricular...

Area of Science:

• Pediatric Cardiology
• Echocardiography
• Congenital Heart Disease

Background:

• Decreased aortic valve coaptation height is a known indicator of valve failure in adults.
• Ventricular septal defects (VSD) can be associated with aortic cusp prolapse (ACP) and subsequent aortic regurgitation (AR).

Purpose of the Study:

• To evaluate aortic valve coaptation height (CH) and effective height (EH) in healthy children and those with VSD and ACP using echocardiography.
• To assess the utility of novel ACH and AEH indices in determining the severity of VSD with ACP and guiding surgical intervention.

Main Methods:

• Echocardiography was used to measure aortic valve diameter (AV), CH, and EH in 83 healthy controls and 45 children with VSD and ACP (18 developed AR, 27 did not).
• Aortic root anatomy was assessed, and ACH (CH/AV ratio) and AEH (EH/AV ratio) indices were calculated.
• Measurements were compared between groups, and changes in ACH and AEH were analyzed before and after intra-cardiac repair (ICR) in 15 cases.

Main Results:

• Significant differences in ACH and AEH were observed between control, VSD with ACP, and VSD with ACP and AR groups (P < 0.01).
• Median ACH decreased from 35.1% in controls to 32.0% in VSD with ACP and 22.1% in VSD with ACP and AR.
• Median AEH decreased from 52.0% in controls to 48.0% in VSD with ACP and 34.4% in VSD with ACP and AR.
• Following ICR, significant increases in ACH (27.0% to 32.7%) and AEH (38.5% to 45.8%) were noted (P < 0.05).

Conclusions:

• ACH and AEH are valuable non-invasive echocardiographic markers for assessing the severity of VSD with ACP.
• These indices can assist clinicians in determining the optimal timing for surgical intervention in affected children.