Heart valve disease (aortic valve disease): anatomy and pathology of the aortic valve

2016 ◽  
Author(s):  
Cristina Basso ◽  
Gaetano Thiene ◽  
Siew Yen Ho
Keyword(s):  
Aortic Valve ◽  
Aortic Wall ◽  
Ascending Aorta ◽  
Valve Disease ◽  
Heart Valve Disease ◽  
Distinctive Features ◽  
Aorta Aneurysm ◽  
Rheumatic Valve Disease ◽  
Relationship Of ◽  
The Relationship

The gross features of the aortic valve apparatus, consisting of three semilunar leaflets, three interleaflet triangles, three commissures, and the aortic wall, are discussed both in terms of normal and pathological anatomy. The concept of aortic annulus and the relationship of the aortic valve with the coronary arteries, the membranous septum, and conduction system and the mitral valve are addressed. When dealing with pathology, the chapter focuses on the main distinctive features of aortic valve stenosis and aortic valve incompetence. Regarding the former, the abnormalities reside in the cusps, either two or three in number, with cusp thickening, and calcification with or without commissural fusion (thus distinguishing senile and chronic rheumatic valve disease); in the latter, the gross changes can affect either the cusps (infective endocarditis with tissue perforation/laceration and rheumatic valve disease with tissue retraction) or the aortic wall (ascending aorta aneurysm either inflammatory or degenerative). The distinctive gross abnormalities in the various conditions are illustrated.

scholarly journals Bicuspid aortic valve morphology and aortic valvular outflow jets: an experimental analysis using an MRI-compatible pulsatile flow circulation system

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kaoru Hattori ◽  
Natsuki Nakama ◽  
Jumpei Takada ◽  
Gohki Nishimura ◽  
Ryo Moriwaki ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Pulsatile Flow ◽  
Aortic Wall ◽  
Ascending Aorta ◽  
Circulation System ◽  
Resonance Imaging ◽  
Left Posterior ◽  
Flow Circulation ◽  
The Right

AbstractThe characteristics of aortic valvular outflow jet affect aortopathy in the bicuspid aortic valve (BAV). This study aimed to elucidate the effects of BAV morphology on the aortic valvular outflow jets. Morphotype-specific valve-devising apparatuses were developed to create aortic valve models. A magnetic resonance imaging-compatible pulsatile flow circulation system was developed to quantify the outflow jet. The eccentricity and circulation values of the peak systolic jet were compared among tricuspid aortic valve (TAV), three asymmetric BAVs, and two symmetric BAVs. The results showed mean aortic flow and leakage did not differ among the five BAVs (six samples, each). Asymmetric BAVs demonstrated the eccentric outflow jets directed to the aortic wall facing the smaller leaflets. In the asymmetric BAV with the smaller leaflet facing the right-anterior, left-posterior, and left-anterior quadrants of the aorta, the outflow jets exclusively impinged on the outer curvature of the ascending aorta, proximal arch, and the supra-valvular aortic wall, respectively. Symmetric BAVs demonstrated mildly eccentric outflow jets that did not impinge on the aortic wall. The circulation values at peak systole increased in asymmetric BAVs. The bicuspid symmetry and the position of smaller leaflet were determinant factors of the characteristics of aortic valvular outflow jet.

scholarly journals P24: MANAGEMENT OF RHEUMATIC VALVE DISEASE OF THE AORTIC VALVE USING THE OZAKI PROCEDURE WITH AUTOLOGOUS PERICARDIUM

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
A Asif ◽  
M Caputo
Keyword(s):  
Aortic Valve ◽  
Intraoperative Complications ◽  
Valve Disease ◽  
Severe Aortic Regurgitation ◽  
Autologous Pericardium ◽  
End Diastolic Volume ◽  
Rheumatic Valve Disease ◽  
Coronary Cusp ◽  
Valve Pathology ◽  
Diastolic Murmur

Abstract Case-Study A 15-year-old boy was referred to our tertiary centre from his local paediatric services with a background of rheumatic fever, severe aortic regurgitation (AR) and mild to moderate mitral regurgitation. He had a history of angina and dyspnoea on exertion, a 2/6 ejection systolic murmur and 2/4 end diastolic murmur. Transthoracic echocardiography showed severe aortic valve insufficiency (with flow reversal seen in the descending aorta and an LV end diastolic volume of 173 ml/m2) and trivial pulmonary valve regurgitation. Autograft failure following the favoured Ross procedure deemed the patient as a candidate for an Ozaki procedure. Autologous pericardium was used to replace the diseased aortic valve. Intraoperative transoesophageal echocardiography showed a deficient left coronary cusp leaflet and a retracted right coronary cusp leaflet. The patient was under cardiopulmonary bypass for 124 minutes and on cross-clamping for 99 minutes with no intraoperative complications. Histological examination of the aortic valve leaflets showed neovascularisation, myxoid changes and disarray of the fibrous stroma. Postoperative recovery was uneventful. The postoperative echocardiogram showed trivial AR, end diastolic volume 217ml, end systolic volume 12 ml and 40% ejection fraction. There was full resolution of the dyspnoea, angina and diastolic murmur on follow-up 4-months postoperatively as supported by healthy valve function on echocardiography. This case highlights that in those of risk of multiple valve pathology, such as in rheumatic valve disease, an Ozaki procedure using autologous pericardium is a viable surgical option for paediatric aortic valve repair with good outcomes. Take-home message In cases of systemic conditions affecting the heart valves where there is multiple valve pathology and risk of autograft failure, such as rheumatic valve disease, the use of autologous pericardium to replace these valves has shown to be a viable option in this paediatric case.

scholarly journals AVIATOR: An open international registry to evaluate medical and surgical outcomes of aortic valve insufficiency and ascending aorta aneurysm

2019 ◽  
Vol 157 (6) ◽  
pp. 2202-2211.e7 ◽  
Author(s):  
Frederiek de Heer ◽  
Jolanda Kluin ◽  
Gebrine Elkhoury ◽  
Guillaume Jondeau ◽  
Maurice Enriquez-Sarano ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Surgical Outcomes ◽  
Ascending Aorta ◽  
Aortic Valve Insufficiency ◽  
Aorta Aneurysm ◽  
International Registry ◽  
Valve Insufficiency

scholarly journals Combined Replacement of Aortic Valve and Ascending Aorta—A 70-Year Evolution of Surgical Techniques

Aorta ◽  
2021 ◽  
Author(s):  
Igor Vendramin ◽  
Uberto Bortolotti ◽  
Davide Nunzio De Manna ◽  
Andrea Lechiancole ◽  
Sandro Sponga ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Elderly Patients ◽  
Aortic Valve Disease ◽  
Surgical Techniques ◽  
Ascending Aorta ◽  
Valve Disease ◽  
Long Term Results ◽  
The Past ◽  
Technical Advances

AbstractSimultaneous replacement of the ascending aorta and aortic valve has always been a challenging procedure. Introduction of composite conduits, through various ingenious procedures and their modifications, has changed the outlook of patients with aortic valve disease and ascending aorta pathology. In the past 70 years, progress of surgical techniques and prosthetic materials has allowed such patients to undergo radical procedures providing excellent early and long-term results in both young and elderly patients. This article aims to review the most important technical advances in the treatment of aortic valve disease and ascending aorta aneurysms recognizing the important contributions in this field.

Heart valve disease

2010 ◽  
pp. 2736-2757
Author(s):  
Michael Henein
Keyword(s):  
Developing Countries ◽  
North America ◽  
Heart Valve ◽  
Valve Disease ◽  
Heart Valve Disease ◽  
Northern Europe ◽  
Diagnostic Investigation ◽  
Rheumatic Valve Disease ◽  
Valve Pathology

Rheumatic valve disease remains prevalent in developing countries, but over the last 50 years there has been a decline in the incidence of rheumatic valve disease and an increase in the prevalence of degenerative valve pathology in northern Europe and North America. In all forms of valve disease, the most appropriate initial diagnostic investigation is almost always the echocardiogram....

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