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Fetal Anatomy: The Aortic Valve in Fetal Aortic Valve Diseases

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Fetal and Hybrid Procedures in Congenital Heart Diseases
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Abstract

The pathology of aortic valve diseases can manifest at subvalvular, valvular, or supravalvular level. Fetal supravalvular aortic stenosis is very rare, while subvalvular stenosis is encountered more often in the setting of complex congenital defect. The most common fetal aortic valve diseases are represented by atresia or valvular stenosis. This is often characterized by restricted cusps excursion and post-stenotic dilatation of the ascending aorta. In aortic atresia an imperforate membrane is guarding the aortic severe hypoplastic annulus and ascending aorta. The blood flow and pressure reduction on the left side of the heart during gestation impact on the remodeling cardiac process leading to hypoplastic left heart syndrome.

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References

  1. Frescura C, Ho SY, Thiene G. La collezione anatomica di cardiopatie congenite dell’Università di Padova. Cleup, Padova 1996.

    Google Scholar 

  2. Anderson RH, Devine WA, Ho SY, Smith A, McKay R. The myth of the aortic annulus: the anatomy of the subaortic outflow tract. Ann Thorac Surg. 1991;52:640–6. J Heart Valve Dis. 5 Suppl 3:S272-5.

    Article  CAS  PubMed  Google Scholar 

  3. Ho SY. Structure and anatomy of the aortic root. Eur J Echocardiogr. 2009;10:i3–10.

    Article  PubMed  Google Scholar 

  4. Sievers HH, Hemmer W, Beyersdorf F, Moritz A, Moosdorf R, Lichtenberg A, Misfeld M, Charitos EI, Working Group for Aortic Valve Surgery of German Society of Thoracic and Cardiovascular Surgery. The everyday used nomenclature of the aortic root components: the tower of Babel? (2012). Eur J Cardiothorac Surg. 2012;41:478–82.

    Article  PubMed  Google Scholar 

  5. Yamamoto Yand Hornberger LK. Progression of outflow tract obstruction in the fetus. Early Hum Dev. 2012;88:279–85.

    Article  Google Scholar 

  6. Angelini A, Ho SY, Anderson RH, Devine WA, Zuberbuhler JR, Becker AE, Davies MJ. The morphology of the normal aortic valve as compared with the aortic valve having two leaflets. J Thorac Cardiovasc Surg. 1989;98:362–7.

    CAS  PubMed  Google Scholar 

  7. Duran AC, Frescura C, Sans-Coma V, Angelini A, Basso C, Thiene G. Bicuspid aortic valves in hearts with other congenital heart disease. J Heart Valve Dis. 1995;4:581–90.

    CAS  PubMed  Google Scholar 

  8. Frescura C, Thiene G. Small aortic root in neonates. J Heart Valve Dis. 1996;Suppl 3:S272–5.

    Google Scholar 

  9. Maizza AF, Ho SY, Anderson RH. Obstruction of the left ventricular outflow tract: anatomical observations and surgical implications. J Heart Valve Dis. 1993;2:66–79.

    CAS  PubMed  Google Scholar 

  10. Arzt W, Wertaschnigg D, Veit I, Klement F, Gitter R, Tulzer G. Intrauterine aortic valvuloplasty in fetuses with critical aortic stenosis: experience and results of 24 procedures. Ultrasound Obstet Gynecol. 2011;37:689–95.

    Article  CAS  PubMed  Google Scholar 

  11. Freud LR, McElhinney DB, Marshall AC, Marx GR, Friedman KG, del Nido PJ, Emani SM, Lafranchi T, Silva V, Wilkins-Haug LE, Benson CB, Lock JE, Tworetzky W. Fetal aortic valvuloplasty for evolving hypoplastic left heart syndrome: postnatal outcomes of the first 100 patients. Circulation. 2014;130:638–45.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Marantz P, Grinenco S. Fetal intervention for critical aortic stenosis: advances, research and postnatal follow-up. Curr Opin Cardiol. 2015;30:89–94.

    Article  PubMed  Google Scholar 

  13. Maskatia SA, Ing FF, Justin H, Crystal MA, Mullins CE, Mattamal RJ, O’Brian Smith E, Petit CJ. Twenty-five year experience with balloon aortic valvuloplasty for congenital aortic stenosis. Am J Cardiol. 2011;108:1024–8.

    Article  PubMed  Google Scholar 

  14. McKay R, Smith A, Leung MP, Arnold R, Anderson RH. Morphology of the ventriculoaortic junction in critical aortic stenosis. Implication for hemodynamic function and clinical management. J Thorac Cardiovasc Surg. 1992;104:434–2.

    CAS  PubMed  Google Scholar 

  15. McElhinney DB, Vogel M, Benson CB, Marshall AC, Wilkins-Haug LE, Silva V, Tworetzky W. Assessment of left ventricular endocardial fibroelastosis in fetuses with aortic stenosis and evolving hypoplastic left heart syndrome. Am J Cardiol. 2010;106:1792–7.

    Article  PubMed  Google Scholar 

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Correspondence to Annalisa Angelini .

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Angelini, A., Fedrigo, M., Frescura, C., Thiene, G. (2016). Fetal Anatomy: The Aortic Valve in Fetal Aortic Valve Diseases. In: Butera, G., Cheatham, J., Pedra, C., Schranz, D., Tulzer, G. (eds) Fetal and Hybrid Procedures in Congenital Heart Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-40088-4_5

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  • DOI: https://doi.org/10.1007/978-3-319-40088-4_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40086-0

  • Online ISBN: 978-3-319-40088-4

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