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[Detection of aortic valve prolapse by cross-sectional echocardiography (author's transl)]
Insights
Aortic valve prolapse, a condition previously understudied, was identified in five patients using echocardiography. This finding suggests it may be a common cause of aortic regurgitation.
Area of Science:
- Cardiology
- Medical Imaging
- Valvular Heart Disease
Background:
- Echocardiography is a standard tool for detecting mitral and tricuspid valve prolapse.
- Recognition of aortic valve prolapse using echocardiography has not been extensively studied.
Observation:
- A cross-sectional echocardiographic study was conducted on 1700 consecutive cases.
- Criteria for aortic valve prolapse included eccentric coaptation, asymmetric cusp enlargement, and downward cusp displacement.
- Five cases of aortic valve prolapse were identified, categorized into three morphological patterns based on the affected cusp.
Findings:
- All five identified cases of aortic valve prolapse exhibited significant aortic regurgitation.
- No cases of mitral valve prolapse were observed in conjunction with aortic valve prolapse.
- The identified cases involved prolapse of the right coronary cusp (1), left coronary cusp (1), and noncoronary cusp (3).
Implications:
- Aortic valve prolapse may represent a significant, previously underestimated cause of aortic regurgitation.
- Further extensive research is necessary to fully elucidate the spectrum and clinical significance of aortic valve prolapse.
Abstract:
Echocardiography has been widely used for a detection of mitral and tricuspid valve prolapse. However, no extensive study has been made for a recognition of aortic valve prolapse. In this study, an echocardiographic search for aortic valve prolapse was attempted on 1700 consecutive cases at our laboratory including 70 cases with aortic regurgitation and 30 with mitral valve prolapse. Criteria of aortic valve prolapse by cross-sectional echocardiography were as follows: (1) eccentric coaptation point of aortic valve cusps, (2) asymmetric enlargement of the aortic valve cusp, and (3) downward displacement of the cusps. Using the above-mentioned criteria, five cases were recognized as having aortic valve prolapse, and it was divided into the following three morphological patterns: (1) prolapse of the right coronary cusp (1 case), (2) prolapse of the left coronary cusp (1) case, and (3) prolapse of the noncoronary cusp (3 cases). All 5 cases showed apparent aortic regurgitation, while none of these cases had any evidence of mitral valve prolapse. From the present observations, it might be suggestive that aortic valve prolapse is one of the common causes of aortic regurgitation. Elucidation of a spectrum of aortic valve prolapse should wait for a further extensive study.