Prevalence of aortic valve regurgitation in a large population-based study of newborns

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Farooqui ◽  
J.K Bjerrekaer ◽  
M.F Boerresen ◽  
R.O Voegg ◽  
C.A Pihl ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Population Based ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Large Cohort ◽  
Funding Source ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
True Prevalence

Abstract Background Congenital aortic valve regurgitation (AVR) has been estimated to be present in 0.25 per 1,000 live births globally. The true prevalence in an unselected large-scale cohort remains unknown. Presence of congenital AVR could indicate a structural valve abnormality and may result in long-term strain on the heart. Aim To find the true prevalence of AVR in a large cohort of unselected newborns. Methods Between April 2016 and October 2018, 25,752 newborns were consecutively included in a population-based prospective multicenter cohort and examined with transthoracic echocardiography within the first 30 days of life. Examinations with AVR were categorized as trivial AVR by the presence of a trivial diastolic transvalvular flow, or as non-trivial AVR by the presence of a significantly larger and visually observable transvalvular flow. In newborns with non-trivial AVR, the vena contracta, the duration of the transvalvular flow, and the duration of the diastole were measured. The cases were matched 1:4 with newborns with no AVR based on sex, gestational age at birth, birth weight and age at time of examination. Results AVR was identified in 329 newborns (1.3%). Of these, 260 were classified as trivial AVR, 69 (0.27%) were non-trivial AVR. Non-trivial AVR had significantly larger aortic roots at all points of measurement compared to controls (mean±SD): aortic valve annulus (7.3 (0.73) vs. 7.0 (0.63) mm), Sinus of Valsalva (10.3 (1.0) vs. 9.7 (1.0) mm), sino-tubular junction (8.4 (0.8) vs. 8 (0.8) mm), and ascending aorta (10 (0.9) vs. 9.4 (1.1) mm) (p<0.01 for all). Left ventricular dimensions and function did not significantly differ between the cases and controls. The presence of a non-trivial AVR was highly associated with a bicuspid aortic valve (9 (13.0%) vs. 3 (1.1%), p<0.001). Conclusions We found a prevalence of congenital AVR of 1.3% in a large cohort of unselected newborns, which is higher than previously reported. One in five of all AVR found were classified as non-trivial. Newborns with non-trivial AVR presented with larger aortic root and ascending aorta dimensions. Newborns with non-trivial AVR also had a ten-fold higher occurrence of bicuspid aortic valve compared to controls. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Hjerteforeningen

scholarly journals Developmental changes in bicuspid aortic valve and associated aortopathy in small children

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Boesgaard Norsk ◽  
A S Sillesen ◽  
A Axelsson Raja ◽  
M Munk Paerregaard ◽  
C Pihl ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Flow Velocity ◽  
Bicuspid Aortic Valve ◽  
Ascending Aorta ◽  
Early Years ◽  
Z Score ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Valve Annulus

Abstract Background The prevalence of bicuspid aortic valve (BAV) in newborns is 0.8%. BAV is associated with an increased risk of aortic valve dysfunction and aortopathy. Aortopathy with increased aortic diameters has recently been reported in newborns with BAV. As most patients with BAV are diagnosed in adulthood the development of BAV and associated aortopathy during early years of life is not well described. Purpose The purpose of the study was to assess changes in aortic valve function and aortic dimensions at two to four years of age in children diagnosed with BAV neonatally. Methods Children with BAV were included from a population-based cohort study, in which newborns (n≈25,000) underwent standardized transthoracic echocardiography (TTE). Follow-up TTE was performed and analyzed according to established guidelines. Neonatal (baseline) and follow-up data were compared. Diameters were indexed to body surface area (BSA). Z-scores were calculated using formulas from the Pediatric Heart Network Echocardiogram Database. Results At follow-up 101 newborns with BAV (mean age 2 years 5 months, SD 11 months), 75% male) were examined from May 2019 to April 2021. From baseline to follow-up there was an increase in the BSA-adjusted diameter of the aortic valve annulus (z-score −0.19 at baseline vs 0.95 at follow up, p<0.001), and of the sino-tubular junction (z-score 0.16 at baseline vs 0.43 at follow up, p<0.05). Conversely, there was a decrease in the Z-score for the diameter measured 1 cm from the valve annulus (z-score 1.31 at baseline vs 0.68 at follow up, p<0.001) and at the widest point of the visualized ascending aorta (z-score 2.44 at baseline vs 1.45 at follow up, p<0.001). There was no significant change in the diameter of the sinus of Valsalva (z-score 0.83 at baseline vs 0.80 at follow up, p=0.92). The number of children with at least one aortic z-score >3 was 31 (30.6%) at baseline and 17 (17.8%) at follow up. At baseline mild aortic valve regurgitation was observed in 18 children (17.8%) and in 23 children at follow up (23%). Mean maximum systolic velocities across the aortic valve were 1.03 m/s at baseline (SD 0.24) and 1.11 m/s at follow up (SD 0.27), p<0.05. Aortic stenosis, defined as flow velocity >2.5 m/s was seen in one child both at baseline and at follow-up. Conclusion In children diagnosed with BAV neonatally, re-examination at the age of 2.5 years showed significant increases in the diameter of the aortic valve annulus and the sino-tubular junction, but a significant decrease in the diameter of the ascending aorta. The maximum blood flow velocity across the aortic valve increased and more children had developed mild aortic valve regurgitation. Thus, the bicuspid aortic valve and the associated aortopathy seem to undergo remodeling during early childhood. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The Danish Children's Heart Foundation, Boernehjertefonden.

scholarly journals Aortic valve regurgitation and the congenitally bicuspid aortic valve: a clinico-pathological correlation.

Heart ◽  
1992 ◽  
Vol 67 (6) ◽  
pp. 439-441 ◽  
Author(s):  
A S Sadee ◽  
A E Becker ◽  
H A Verheul ◽  
B Bouma ◽  
G Hoedemaker
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Pathological Correlation

scholarly journals Natural history and clinical effect of aortic valve regurgitation after left ventricular assist device implantation

2013 ◽  
Vol 145 (5) ◽  
pp. 1373-1379 ◽  
Author(s):  
Keshava Rajagopal ◽  
Mani A. Daneshmand ◽  
Chetan B. Patel ◽  
Asvin M. Ganapathi ◽  
Matthew A. Schechter ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Natural History ◽  
Clinical Effect ◽  
Left Ventricular ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Assist Device ◽  
Ventricular Assist ◽  
Device Implantation ◽  
Left Ventricular Assist

Progressive dilation of the diameter of the aortic root in adults with a bicuspid aortic valve

2003 ◽  
Vol 13 (6) ◽  
pp. 526-531 ◽  
Author(s):  
Annie Dore ◽  
Marie-Claude Brochu ◽  
Jean-François Baril ◽  
Marie-Claude Guertin ◽  
Lise-Andrée Mercier
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Left Ventricular Outflow Tract ◽  
Normal Population ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Rate Of Progression ◽  
Left Ventricular Outflow

Background: To determine the rate of progression of dilation of the aortic root in adults with a bicuspid aortic valve. Methods: We reviewed retrospectively the transthoracic echocardiograms of 50 adults with a bicuspid aortic valve. Each patient had had at least two examinations made 12 months apart. Measurements were taken at four levels: at the basal attachment of the leaflets of the valve within the left ventricular outflow tract, at the widest point of the sinuses of Valsalva, at the sinutubular junction, and in the ascending aorta 1 cm beyond the sinutubular junction. Results: Progressive dilation occurred at all levels, ranging from 0.3 mm/yr at the basal attachment within the left ventricular outflow tract to 1.0 mm/yr, 1 cm beyond sinutubular junction. These rates of dilation were greater than the reported rate of 0.8 mm per decade in the normal population. The rate of dilation found in the ascending aorta 1 cm beyond the sinutubular junction was significantly greater than at the other sites (p = 0.005). The 21 patients with baseline measurements greater than 34 mm had a significantly higher rate of progression (p = 0.007). Sex, age, and the degree of valvar obstruction or regurgitation did not significantly influence the rate of progression of dilation. Conclusion: There is a significantly higher rate of dilation of the aortic root in adults with a bicuspid aortic valve when compared to the normal population. Periodic evaluation of the ascending aorta is essential in these patients, even after replacement of the aortic valve. Other imaging modalities should be considered if the region beyond the sinutubular junction is not well visualized by transthoracic echocardiography.

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