Roberts William C, Ko Jong M
Baylor Heart and Vascular Institute and the Department of Pathology, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX 75246, USA.
Circulation. 2005 Feb 22;111(7):920-5. doi: 10.1161/01.CIR.0000155623.48408.C5. Epub 2005 Feb 14.
Aortic valve stenosis (with or without aortic regurgitation and without associated mitral stenosis) in adults in the Western world has been considered in recent years to most commonly be the result of degenerative or atherosclerotic disease.
We examined operatively excised, stenotic aortic valves from 932 patients aged 26 to 91 years (mean+/-SD, 70+/-12), and none had associated mitral valve replacement or evidence of mitral stenosis: A total of 504 (54%) had congenitally malformed valves (unicuspid in 46 [unicommissural in 42; acommissural in 4] and bicuspid in 458); 417 (45%) had tricuspid valves (either absent or minimal commissural fusion); and 11 (1%) had valves of undetermined type. It is likely that the latter 11 valves also had been congenitally malformed. Of the 584 men, 343 (59%) had either a unicuspid or a bicuspid valve; of the 348 women, 161 (46%) had either a unicuspid or a bicuspid aortic valve.
The data from this large study of adults having isolated aortic valve replacement for aortic stenosis (with or without associated aortic regurgitation) and without associated mitral stenosis or mitral valve replacement strongly suggest that an underlying congenitally malformed valve, at least in men, is more common than a tricuspid aortic valve.
近年来，西方世界成年人的主动脉瓣狭窄（伴或不伴主动脉瓣反流且无相关二尖瓣狭窄）被认为最常见的病因是退行性或动脉粥样硬化性疾病。
我们检查了932例年龄在26至91岁（平均±标准差，70±12）患者的手术切除的狭窄主动脉瓣，且均无相关二尖瓣置换或二尖瓣狭窄证据：共有504例（54%）患者的瓣膜先天性畸形（46例为单叶瓣[42例为单交界瓣；4例为无交界瓣]，458例为二叶瓣）；417例（45%）患者的瓣膜为三叶瓣（要么无融合交界，要么融合交界极少）；11例（1%）患者的瓣膜类型无法确定。很可能后11例患者的瓣膜也存在先天性畸形。在584名男性中，343例（59%）有单叶瓣或二叶瓣；在348名女性中，161例（46%）有单叶瓣或二叶主动脉瓣。
这项针对因主动脉瓣狭窄（伴或不伴相关主动脉瓣反流）且无相关二尖瓣狭窄或二尖瓣置换而进行单纯主动脉瓣置换的成年患者的大型研究数据强烈表明，至少在男性中，潜在的先天性畸形瓣膜比三叶主动脉瓣更常见。
