Department of Nursing, National Tainan Institute of Nursing, Tainan, Taiwan.
Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
J Mater Sci Mater Med. 2018 Jun 5;29(6):80. doi: 10.1007/s10856-018-6087-8.
Bicuspid aortic valve (BAV) is an inherited form of heart disease with only two aortic valve leaflets via a disorder of cardiac valvulogenesis. We investigated the in vivo echocardiographic features of cardiac morphology in patients with BAV and the ex vivo compositional components of all the excised BAV leaflets isolated from BAV patients. Three BAV patients were randomly selected. All patients underwent 2D transthoracic echocardiography (TTE) with a Doppler ultrasound tool. The compositional components of each respective BAV leaflet for all the excised BAVs were determined by a portable fiber-optic Raman spectroscopy. Preoperative TTE revealed the thickened and calcified BAV leaflets, and stenotic aortic flow for all BAV patients. These BAV patients exhibited severe aortic stenosis (AS) by the lower values of aortic valve area (AVA) index. One patient showed a more significant left ventricle hypertrophy, whereas two patients exhibited a significant aortic regurgitation (AR). In addition, three different Raman spectral patterns were summed up from 121 randomized Raman determinations for all the excised BAV leaflets. The main calcified deposition in each BAV leaflet was formed by large amounts of calcium hydroxyapatite and type-B carbonate apatite (Raman bands at 960 and 1070 cm). The calcified BAV leaflets were composed of different compositional components such as calcium hydroxyapatite, type-B carbonate apatite, lipids, proteins, cholesterol and β-carotene. The rare NL subtype of type 1 BAV morphotype was found in one patient, but two patients had the purely BAV morphotype with two equal-sized leaflets.
二叶式主动脉瓣（BAV）是一种遗传性心脏病，其病因是心脏瓣膜发生了病变，只有两个主动脉瓣叶。我们研究了 BAV 患者的活体心脏形态学的超声心动图特征，以及从 BAV 患者体内分离的所有 BAV 瓣叶的体外组成成分。随机选择了 3 名 BAV 患者。所有患者均接受了二维经胸超声心动图（TTE）和多普勒超声检查。使用便携式光纤拉曼光谱仪确定了所有切除的 BAV 瓣叶的各自组成成分。术前 TTE 显示所有 BAV 患者的 BAV 瓣叶增厚、钙化，主动脉瓣口狭窄，主动脉血流受限。所有 BAV 患者的主动脉瓣口面积（AVA）指数均较低，表现为严重的主动脉瓣狭窄（AS）。1 名患者左心室肥厚更明显，2 名患者表现为严重的主动脉瓣反流（AR）。此外，对所有切除的 BAV 瓣叶进行了 121 次随机拉曼测定，总结出 3 种不同的拉曼光谱模式。每个 BAV 瓣叶中的主要钙化沉积是由大量的羟基磷灰石和 B 型碳酸磷灰石组成（拉曼带在 960 和 1070 cm）。钙化的 BAV 瓣叶由不同的组成成分组成，如羟基磷灰石、B 型碳酸磷灰石、脂质、蛋白质、胆固醇和β-胡萝卜素。在 1 名患者中发现了罕见的 NL 型 1 型 BAV 形态，而在另外 2 名患者中，BAV 形态为两个等大小的瓣叶。
