Abstract
Objective:To assess the utility of transthoracic echocardiography (TTE) with second harmonic combined with transesophageal echocardiography (TEE) in defining aortic valve morphology in a subset of patients with a high prevalence of bicuspid aortic valve. Methods and Materials: Patients (n=174) with dilated aortic root were consecutively evaluated using, initially, TTE. The aortic valve structure was assigned as tricuspid, bicuspid or undefined. In those assigned as bicuspid or undefined, TEE was performed. Other factors that could affect valve morphology assignment were recorded and evaluated in multivariate analysis. Results: TTE was able to characterise 89% of the tricuspid valves and 56% of the bicuspid. Bicuspid structure was the only variable that, in the multivariate analysis, was related to the inability to definitively assign aortic valve morphology (OR=0.13). TEE was performed in 59 patients and the morphology was definitively assigned in 56 of them (95%). TEE diagnosed 15 bicuspid valves in addition to confirming the 17 identified by TTE. Overall, using TTE combined with TEE we were able to correctly assign valvular morphology in 98% of patients. Conclusion: In a subset of patients with a high prevalence of bicuspid aortic valve, combination of TTE and TEE should be considered to define aortic valve morphology. TEE identifies an important number of patients with BAV.
Similar content being viewed by others
Abbreviations
- BAV:
-
bicuspid aortic valve
- TEE:
-
transesophageal echocardiography
- TTE:
-
transthoracic echocardiography
References
RO Brandenburg AJ Tajik WD Edwards GS Reeder C Shub JB Seward (1983) ArticleTitleAccuracy of 2-dimensional echocardiographic diagnosis of congenitally bicuspid aortic valve: echocardiographic–anatomic correlation in 115 patients Am J Cardiol 51 1469–1473 Occurrence Handle10.1016/0002-9149(83)90659-8 Occurrence Handle6846179
K Chan W Stinson J Veinot (1999) ArticleTitleReliability of transthoracic echocardiography in the assessment of aortic valve morphology: pathological correlation in 178 patients Can J Cardiol 15 48–52 Occurrence Handle1:STN:280:DyaK1M7kvV2qtQ%3D%3D Occurrence Handle10024858
M Espinal AR Fuisz NC Nanda SR Aaluri O Mukhtar PC Sekar (2000) ArticleTitleSensitivity and specificity of transesophageal echocardiography for determination of aortic valve morphology Am Heart J 139 1071–1076 Occurrence Handle10.1067/mhj.2000.103843 Occurrence Handle1:STN:280:DC%2BD3c3oslartw%3D%3D Occurrence Handle10827389
C Ward (2000) ArticleTitleClinical significance of the bicuspid aortic valve Heart 83 81–85 Occurrence Handle1:STN:280:DC%2BD3c%2FoslCgsw%3D%3D Occurrence Handle10618341
JM Alegret I Duran O Palazón et al. (2003) ArticleTitlePrevalence of and predictors of bicuspid aortic valves in patients with dilated aortic root Am J Cardiol 91 619–622 Occurrence Handle12615278
HY Sabet WD Edwards HD Tazelaar RC Daly (1999) ArticleTitleCongenitally bicuspid aortic valves: a surgical pathology study of 542 cases (1991 through 1996) and a literature review of 2,715 additional cases Mayo Clin Proc 74 14–26 Occurrence Handle1:STN:280:DyaK1M7kt1Sjsw%3D%3D Occurrence Handle9987528
CC Lamas SJ Eykyn (2000) ArticleTitleBicuspid aortic valve A silent danger: analysis of 50 cases of infective endocarditis Clin Infect Dis 30 336–341 Occurrence Handle1:STN:280:DC%2BD3c7jslOrsg%3D%3D Occurrence Handle10671338
CS Roberts WC Roberts (1991) ArticleTitleDissection of the aorta associated with congenital malformation of the aortic valve J Am Coll Cardiol 17 712–717 Occurrence Handle1:STN:280:By6C3s7ptV0%3D Occurrence Handle1993792
RT Pachulski AL Weinberg KL Chan (1991) ArticleTitleAortic aneurysm in patients with functionally normal or minimally stenotic bicuspid aortic valve Am J Cardiol 67 781–782 Occurrence Handle1:STN:280:By6C2svgtF0%3D Occurrence Handle2006634
WC Roberts (1970) ArticleTitleThe congenitally bicuspid aortic valve: a study of 85 autopsy cases Am J Cardiol 26 72–83 Occurrence Handle10.1016/0002-9149(70)90761-7 Occurrence Handle1:STN:280:CS%2BB3s3gsVQ%3D Occurrence Handle5427836
K Huntington AG Hunter KL Chan (1997) ArticleTitleA prospective study to assess the frequency of familial clustering of congenital bicuspid aortic valve J Am Coll Cardiol 30 1809–1812 Occurrence Handle1:STN:280:DyaK1c%2FksFKkug%3D%3D Occurrence Handle9385911
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Alegret, J.M., Palazón, O., Duran, I. et al. Aortic valve morphology definition with transthoracic combined with transesophageal echocardiography in a population with high prevalence of bicuspid aortic valve. Int J Cardiovasc Imaging 21, 213–217 (2005). https://doi.org/10.1007/s10554-004-3901-9
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10554-004-3901-9