Published online before print February 14, 2005, doi: 10.1161/01.CIR.0000155623.48408.C5
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(Circulation. 2005;111:920-925.)
© 2005 American Heart Association, Inc.
Valvular Heart Disease |
Frequency by Decades of Unicuspid, Bicuspid, and Tricuspid Aortic Valves in Adults Having Isolated Aortic Valve Replacement for Aortic Stenosis, With or Without Associated Aortic Regurgitation
From the Baylor Heart and Vascular Institute and the Departments of Pathology and Medicine, Baylor University Medical Center, Dallas, Tex.
Correspondence to William C. Roberts, MD, Baylor Heart and Vascular Institute, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX 75246. E-mail wc.roberts{at}baylorhealth.edu
Received August 27, 2004; revision received November 22, 2004; accepted December 13, 2004.
Background— Aortic valve stenosis (with or without aortic regurgitation and without associated mitral stenosis) in adults in the Western world has been considered in recent years to most commonly be the result of degenerative or atherosclerotic disease.
Methods and Results— We examined operatively excised, stenotic aortic valves from 932 patients aged 26 to 91 years (mean±SD, 70±12), and none had associated mitral valve replacement or evidence of mitral stenosis: A total of 504 (54%) had congenitally malformed valves (unicuspid in 46 [unicommissural in 42; acommissural in 4] and bicuspid in 458); 417 (45%) had tricuspid valves (either absent or minimal commissural fusion); and 11 (1%) had valves of undetermined type. It is likely that the latter 11 valves also had been congenitally malformed. Of the 584 men, 343 (59%) had either a unicuspid or a bicuspid valve; of the 348 women, 161 (46%) had either a unicuspid or a bicuspid aortic valve.
Conclusions— The data from this large study of adults having isolated aortic valve replacement for aortic stenosis (with or without associated aortic regurgitation) and without associated mitral stenosis or mitral valve replacement strongly suggest that an underlying congenitally malformed valve, at least in men, is more common than a tricuspid aortic valve.
Key Words: aorta • heart defects, congenital • valves • regurgitation
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