Abstract
The commissurae of the aortic valve may be fused, and the ring is occasionally small. The orifice of the aortic valve can be eccentric. The valve is commonly bicuspid in aortic stenosis and the leaflets are asymmetric in 40% of cases. There is occasionally more than one level of obstruction in the left ventricular outflow tract together with aortic valvular stenosis. About 10% of patients with aortic valvular stenosis have subvalvar aortic stenosis. Supravalvar aortic stenosis is rarely associated with aortic stenosis. In 50% of valvular aortic stenosis patients, a certain degree of aortic insufficiency is associated. Aortic valvular stenosis is not always the result of a bicuspid aortic valve, since bicuspid aortic valve is 10-20 times as common as aortic stenosis. Thus, a small number of bicuspid valves leads to aortic stenosis, but the majority will not develop into aortic stenosis. Right-to-left commissures have a worse prognosis in bicuspid aortic than anteroposterior commissures in developing aortic stenosis.
Chapter PDF
Keywords
- Aortic Valve
- Aortic Stenosis
- Bicuspid Aortic Valve
- Ventricular Outflow Tract
- Left Ventricular Outflow Tract
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
References
Adabag AS, Maron BJ, Appelbaum E, Harrigan CJ, Buros JL, Gibson CM, Lesser JR, Hanna CA, Udelson JE, Manning WJ, Maron MS (2008) Occurrence and frequency of arrhythmias in hypertrophic cardiomyopathy in relation to delayed enhancement on cardiovascular magnetic resonance. J Am Coll Cardiol 51: 1369–1374
Ait-Ali L, Aquaro G, Bernabei M, Chiappino D, Farneti A, Kull S, Mariani M, Festa P (2007) MRI evaluation of biophysical proprieties of ascending aorta in bicuspid aortic valve. J Cardiovasc Med 8(Suppl2):37
Arai AE, Epstein FH, Bove KE, Wolff SD (1999) Visualization of aortic valve leaflets using black blood MRI. J Magn Reson Imaging 10:771–777
Cicini MP, Giannico S, Marino B, Iorio FS, Corno AF, Marcelletti C (1992) “Acquired” subvalvular aortic stenosis after repair of a ventricular septal defect. Chest 101:115–118
Corno AF, Hurni M, Griffin H, Jeanrenaud X, von Segesser LK (2001) Glutaraldehyde-fixed bovine jugular vein as a substitute for the pulmonary valve in the Ross operation. J Thorac Cardiovasc Surg 122: 493–494
Corno AF, Chassot PG, Jeanrenaud X, Tozzi P, Wicky S, von Segesser LK (2002) Aortic valve disease: is the Ross operation the solution? Med Cardiovasc 5 (Suppl 4):46S
Corno AF, von Segesser LK (2003) The stealth Ross operation. Asian Cardiovasc Thorac Ann 11:186
Corno AF, Qanadli SD, Sekarski N, Artemisia S, Hurni M, Tozzi P, von Segesser LK (2004) Bovine valved xenograft in pulmonary position: medium-term follow-up with excellent hemodynamics and freedom from calcifications. Ann Thorac Surg 78:1382–1388
Davtyan HG, Corno AF, Drinkwater DC, George B, Laks H (1986) Valve replacement for congenital heart disease. Circulation 74:II–250
Grotenhuis HB, Ottenkamp J, Westenberg JJ, Bax JJ, Kroft LJ, de Roos A(2007) Reduced aortic elasticity and dilatation are associated with aortic regurgitation and left ventricular hypertrophy in nonstenotic bicuspid aortic valve patients. J Am Coll Cardiol 49:1660–1665
Konno S, Imai Y, Iida Y, Nakajima M, Tatsuno K (1975) A new method for prosthetic valve replacement in congenital aortic stenosis associated with hypoplasia of the aortic valve ring. J Thorac Cardiovasc Surg 70:909
Pierli C, Marino B, Picardo S, Corno AF, Pasquini L, Marcelletti C (1989) Discrete subaortic stenosis: surgery in children based on two dimensional and Doppler echocardiography. Chest 96:325–328
Rastan H, Koncz J (1976) Aortoventriculoplasty. A new technique for the treatment of left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg 71:920
Ross DN (1967) Replacement of aortic and mitral valve with a pulmonary autograft. Lancet 2:956
Sebastià C, Quiroga S, Boyé R, Perez-Lafuente M, Castellà E, Alvarez-Castells A (2003) Aortic stenosis: spectrum of diseases depicted at multisection CT. Radiographics 23:S79–S91
Shone JD, Sellers RD, Anderson RC, Adams P, Lillehei CW, Edwards JE (1963) The developmental complex of parachute mitral valve, supravalvular ring of left atrium, subaortic stenosis and coarctation of the aorta. Am J Cardiol 11:714–725
Stolzmann P, Scheffel H, Bettex D, Karlo C, Frauenfelder T, Prêtre R, Marincek B, Alkadhi H (2007) Subvalvular aortic stenosis: comprehensive cardiac evaluation with dual-source computed tomography. J Thorac Cardiovasc Surg 134:240–242
Wang IJ, Chen SJ, Wang JK, Chang CI, Wu MH (2003) Electron beam computed tomography appearance of endocardial fibroelastosis. Int J Cardiovasc Imaging 19:85–90
Williams JCP, Barrat-Boyes BG, Lowe JB (1961) Supravalvular aortic stenosis. Circulation 24:1311
Rights and permissions
Copyright information
© 2009 Steinkopff Verlag
About this chapter
Cite this chapter
(2009). Left ventricular outflow tract obstruction. In: Congenital Heart Defects. Steinkopff. https://doi.org/10.1007/978-3-7985-1719-6_13
Download citation
DOI: https://doi.org/10.1007/978-3-7985-1719-6_13
Publisher Name: Steinkopff
Print ISBN: 978-3-7985-1718-9
Online ISBN: 978-3-7985-1719-6
eBook Packages: MedicineMedicine (R0)