Abstract
ObjectivesBicuspid aortic valve (BAV) is the most common congenital lesion found in adults. It can be seen in combination with a transverse left ventricular (LV) band. This study aimed to find an essential relationship between the presence of transverse ventricular band and BAV.MethodsA total of 13 patients from a tertiary care centre in India with transverse LV band were investigated during a six-month period from January 2019 to July 2019. LV band thickness and gradients at the site of the LV band were evaluated as part of its effect on LV haemodynamics. The morphology of the aortic valve and LV outflow tract gradients was assessed.ResultsThe mean age of the participants was 41 years. A majority had a BAV (n = 11). Average thickness of the LV band was 6.2 mm and the average mean aortic gradient was 4 mmHg. Sequestration of blood was noted at the level of the transverse band in all the patients with two separate jets at the left ventricular outflow tract. The anterolateral jet was deflected from the transverse band and showed higher velocity compared to the other jet, causing turbulence at the BAV. No correlation was found between the thickness of the transverse band and aortic valve gradient.ConclusionPresence of a robust transverse LV band can serve as a surrogate marker for BAV.
Highlights
- left ventricular (LV) band is likely to play an important role in the haemodynamics of the bicuspid aortic valve (BAV)
Majority (85%) of the patients had a BAV [Figure 1] and transverse LV band was noted in all the patients [Figure 2]
The most robust LV band had a dimension of 8 mm (n = 5), whereas the slenderest band had a dimension of 3 mm (n = 1)
Summary
- LV band is likely to play an important role in the haemodynamics of the bicuspid aortic valve (BAV). - In heavily calcified valves where valve morphology is unclear, detection of a thick robust left ventricular (LV) band may serve as an indicator to the presence of a bicuspid aortic valve (BAV). The development of aortic stenosis imposes undue haemodynamic stress on the left ventricle.[2] BAVs are associated with aortopathy which may be due to genetic or haemodynamic factors. These have far-reaching consequences as they can lead to aortic aneurysm and aortic dissection.[3] Detection of BAV is done mainly with the help of transthoracic echocardiography (TTE). Detection of bicuspid aetiology is necessary as these valves tend to undergo stenosis at an earlier age as compared to the tricuspid valves and can more commonly develop infective endocarditis.[6,7] Regular follow-up is required for the detection of any complications
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