Document Detail


Implications of a congenitally abnormal valve: a study of 1025 consecutively excised aortic valves.
MedLine Citation:
PMID:  17965218     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: An increasing proportion of patients with congenitally abnormal aortic valves (AV) present for AV replacement. AIMS: To review morphological changes in a large contemporary patient population undergoing AV replacement. METHODS: A detailed review was conducted for all 1025 patients who underwent AV replacement from 2002 to 2005, including the clinical indication for surgery, the type of native AV disease, the pathological changes observed in each valve and the need for related surgery. RESULTS: Tricuspid (TAV), bicuspid (BAV) and unicuspid (UAV) aortic valves were observed in 64.5%, 31.9% and 3.0% of all patients respectively. A decreased number of cusps was associated with increasing predilection for male gender (83.9%, 73.4%, 59.2% for UAV, BAV, TAV respectively), a younger patient age at surgery (41.6 (14.3), 61.3 (12.8), 67.5 (12.9) years), and an increased occurrence of pathological changes in the cusps, including calcification of both the cusp and the base, ossification and ulceration. UAV and BAV were also associated with increasing replacement of the ascending aorta due to dilatation and aneurysm formation (54.8, 38.8%, 16.6%). The incidence of infective endocarditis and rheumatic heart disease was 3.8% and 11.2% of all excised valves respectively. CONCLUSION: UAV and BAV were increasingly likely to affect men, fail at an earlier age, and show an increasing incidence of pathological changes in the cusps and ascending aorta than TAV. These results suggest that TAV, BAV and UAV may represent a phenotypic continuum of a similar disease process.
Authors:
M J Collins; J Butany; M A Borger; B H Strauss; T E David
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-10-26
Journal Detail:
Title:  Journal of clinical pathology     Volume:  61     ISSN:  1472-4146     ISO Abbreviation:  J. Clin. Pathol.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-31     Completed Date:  2008-04-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376601     Medline TA:  J Clin Pathol     Country:  England    
Other Details:
Languages:  eng     Pagination:  530-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Pathology, Toronto General Hospital/University Health Network, Toronto, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Aortic Aneurysm / etiology,  pathology,  surgery
Aortic Valve / abnormalities*,  surgery
Aortic Valve Stenosis / etiology,  pathology,  surgery
Calcinosis / etiology,  pathology,  surgery
Endocarditis / complications
Female
Heart Valve Diseases / etiology,  pathology,  surgery
Heart Valve Prosthesis Implantation*
Humans
Male
Middle Aged
Rheumatic Heart Disease / complications
Sex Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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