A classification system for the bicuspid aortic valve with one major category ("type") and two supplementary categories is presented. This classification, even if used in the major category (type) alone, might be advantageous to better define bicuspid aortic valve disease, facilitate scientific communication, and improve treatment.
In regard to aortic regurgitation grade over time, patients with Marfan syndrome and a large preoperative aortic annulus diameter were better treated with the reimplantation technique, whereas those with a smaller diameter were better treated with the remodeling technique. Concomitant free-edge plication of prolapsing cusps was disadvantageous in both groups. Considering these factors may serve to improve the aortic valve longevity after valve-sparing aortic root surgery.
Systolic and diastolic diameters of the right and left pulmonary arteries (RPAD, LPAD), descending thoracic aorta (DTAD), right ventricular infundibulum (RVID), and pulmonary and aortic valve roots at the proximal, commissural and distal levels were estimated from angiocardiograms in 24 infants, children, and adolescents without heart disease, and correlated with body surface area (BSA), stroke volume (SV), cardiac output (CO), and ventricular volumes. The relationships between cardiovascular diameters and BSA were better expressed by a power function than by the other functions tried. We obtained different exponents for pulmonary and aortic valve annuli and the more distally measured great arteries (RPAD, LPAD, and DTAD), suggesting different growth patterns. The right ventricular infundibular shortening fraction (RVISF) was weakly correlated with BSA (r = -0.328), and the values obtained indicated constancy during normal growth. There was a direct proportional relationship between the pulmonary valve annulus diameter and the cube root of the right ventricular volume (r = 0.952), as well as between SV and cross-sections of the right pulmonary artery (RPAC; r = 0.916), left pulmonary artery (LPAC; r = 0.878) and descending thoracic aorta (r = 0.962). RPAC and LPAC were strongly correlated (r = 0.940), the RPAC being significantly larger than the LPAC.
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