Bauer Matthias, Gliech Volker, Siniawski Henryk, Hetzer Roland
Deutsches Herzzentrum Berlin, Division of Internal Medicine, Charité, Berlin, Germany.
J Heart Valve Dis. 2006 Sep;15(5):594-600.
Patients with bicuspid aortic valves (BAV) tend to develop dilatation of the ascending aorta. The study aim was to analyze differences in aortic root diameter and configuration in patients with bicuspid and tricuspid aortic valve disease.
A retrospective analysis was conducted of the angiographies of 461 patients allocated to four groups with: (i) BAV disease with (n = 179) and (ii) without (n = 78) dilatation of the ascending aorta; (iii) tricuspid aortic valve disease (TAV) and dilatation of the ascending aorta (n = 154); and (iv) coronary artery disease (CAD), TAV and normal diameter of the ascending aorta (n=50). Diameters and distances in the aortic root region were measured, and the ascending aorta configuration analyzed.
The diameter of the ascending aorta in patients with BAV and dilatation was significantly larger than in those with TAV and dilatation (26.6 +/- 5.22 versus 24.4 +/- 3.74 mm/m2, p = 0.002). Distances between aortic valve level and point of maximum diameter of the ascending aorta at the outer and inner curve of the vessel in patients with BAV without dilatation were greater than those of the CAD group (31.1 +/- 5.27 versus 28.0 +/- 4.86 mm/m2, p = 0.002 and for the indexed values 21.6 +/- 4.05 versus 20.0 +/- 2.71 mm/m2, p = 0.011). All patients with BAV and enlargement of the ascending aorta showed asymmetric dilatation of the vessel.
All patients with BAV had an abnormal configuration of the ascending aorta. In cases with enlargement of the ascending aorta exclusively, asymmetric dilatation at the convexity of the vessel occurred. Patients with BAV and normal ascending aorta diameter showed an elongation of this vessel segment.
二叶式主动脉瓣（BAV）患者往往会出现升主动脉扩张。本研究旨在分析二叶式和三叶式主动脉瓣疾病患者的主动脉根部直径及形态差异。
对461例患者的血管造影进行回顾性分析，这些患者被分为四组：（i）患有升主动脉扩张的BAV疾病（n = 179）；（ii）不伴有升主动脉扩张的BAV疾病（n = 78）；（iii）三叶式主动脉瓣疾病（TAV）并伴有升主动脉扩张（n = 154）；（iv）冠状动脉疾病（CAD）、TAV且升主动脉直径正常（n = 50）。测量主动脉根部区域的直径和距离，并分析升主动脉形态。
伴有扩张的BAV患者的升主动脉直径显著大于伴有扩张的TAV患者（26.6±5.22对24.4±3.74mm/m²，p = 0.002）。不伴有扩张的BAV患者在血管外侧和内侧曲线上，主动脉瓣水平与升主动脉最大直径点之间的距离大于CAD组（31.1±5.27对28.0±4.86mm/m²，p = 0.002；指数值为21.6±4.05对20.0±2.71mm/m²，p = 0.011）。所有伴有升主动脉扩大的BAV患者均表现出血管不对称扩张。
所有BAV患者的升主动脉形态均异常。仅在升主动脉扩大的病例中，血管凸面出现不对称扩张。BAV且升主动脉直径正常的患者表现为该血管段伸长。
