| Diagnosis of congenital unicuspid aortic valve in adult population: the value and limitation of transesophageal echocardiography. | |
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MedLine Citation:
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PMID: 20553323 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: This study aimed to assess the accuracy of two-dimensional echocardiography (echo) in diagnosing unicuspid aortic valve (UAV) and to determine echo features that could improve the diagnosis. METHOD: We reviewed transthoracic/transesophageal echoes (TTE/TEE) from our hospital database for adult patients who had aortic valve surgery with a preoperative echo diagnosis of UAV or equivocal diagnosis of bicuspid aortic valve (BAV) BAV/UAV. Morphological characteristics of AV and ascending aortic dimensions were evaluated. RESULTS: Nineteen patients were identified, 13 (11 Male, 2 Female, mean age 47 ± 10 years) had surgically confirmed diagnosis of UAV, six had BAV. The incidence of UAV was 2.6%. For diagnosing UAV, the sensitivity and specificity of TTE was 27% and 50% and those of TEE was 75% and 86%, respectively. For TTE, positive predictive value (PPV) was 60% and negative predictive value (NPV) was 20%. By TEE, PPV was 90% and the NPV was 67%. In UAV patients, 85% had severe aortic stenosis (mean gradient 45 ± 16 mmHg, AVA: 0.9 ± 0.2 cm²). 46% had ascending aorta aneurysm (mean aortic root, sinutubular junction, ascending aorta dimensions: 36 ± 3 mm, 31 ± 4 mm and 41 ± 8 mm). Patients with ascending aortic aneurysm were younger (41 ± 11 years vs. 52 ± 5 years, P < 0.05) All UAV were unicommissural with a posteriorly positioned commissural attachment, 69% were heavily calcified. Diagnostic accuracy was limited by quality of images, severity, and distribution of calcification. CONCLUSION: TEE is the diagnostic modality of choice in UAV. Identifying several echo features may improve its diagnostic accuracy. |
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Authors:
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John W Chu; Michael H Picard; Arvind K Agnihotri; Michael G Fitzsimons |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Echocardiography (Mount Kisco, N.Y.) Volume: 27 ISSN: 1540-8175 ISO Abbreviation: Echocardiography Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-11-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8511187 Medline TA: Echocardiography Country: United States |
Other Details:
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Languages: eng Pagination: 1107-12 Citation Subset: IM |
Copyright Information:
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© 2010, Wiley Periodicals, Inc. |
Affiliation:
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Cardiac Ultrasound Laboratory, Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. john.chu@healthotago.co.nz |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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