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J Thorac Cardiovasc Surg 2006;131:1169-1170
© 2006 The American Association for Thoracic Surgery

Brief Communication

Two distinct clinical presentations in adult unicuspid aortic valve

Arvind K. Agnihotri, MD a , * , Shaun C. Desai, BA a , Yong-Qiang Lai, MD b , Michael G. Fitzsimons, MD, FCCP c , Alan D. Hilgenberg, MD a , Gus J. Vlahakes, MD a

a Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
c Division of Cardiac Anesthesiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
b Department of Cardiac Surgery, Anzhen Hospital, Beijing, China.

Received for publication October 20, 2005; accepted for publication November 2, 2005.

* Address for reprints: Arvind K. Agnihotri, MD, Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Edwards Research, 119, 55 Fruit St, Boston, MA 02114 (Email: aagnihotri@partners.org).

The first 20% of the full text of this article appears below.

Unicuspid aortic valve (UAV) is a rare congenital malformation, seen in approximately 0.02% of patients referred for echocardiography but in as many as 4% to 6% of patients undergoing operations for "pure aortic stenosis." 1,2 Go Of the two pathologic types, the acommisural and the unicommisural, the latter predominates in both adult and pediatric populations (Figure 1). Aortic dilatation is known to be frequent in this condition, but limited information exists.


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  		Figure 1. Severely calcified, unicommisural UAV.

 
Patients

Between January 1, 2002, and January 1, 2005, 12 patients with UAV, confirmed by both intraoperative transesophageal echocardiography and surgical inspection, underwent valve surgery at one institution (1.8% of 671 cases). The transesophageal echocardiogram was reviewed for the following: aortic valve area, diameter of the ascending aorta, maximal and mean transaortic valve gradient, grade of aortic insufficiency, and left ventricular ejection fraction.

Eleven (92%) of the patients were male. Age at surgery ranged from 24 to 58 years (mean: 44 ± 9 years [1 SD]). The presenting symptoms . . . [Full Text of this Article]




This article has been cited by other articles:


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R. M. Sniecinski, J. S. Shanewise, and K. E. Glas
Transesophageal Echocardiography of a Unicuspid Aortic Valve
Anesth. Analg., March 1, 2009; 108(3): 788 - 789.
[Full Text] [PDF]


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