The application value of echocardiography in diagnosis and treatment of bicuspid aortic valve and its major complications

Abstract

Objective To investigate the value of echocardiography in diagnosis and treatment of patients with bicuspid aortic valve (BAV). Methods Echocardiographic and clinical data of BAV patients who admitted to Zhongshan Hospital, Fudan University from January 2017 to October 2017 were collected. According to their echocardiographic mean pressure gradient , the patients with aortic stenosis (AS) were split into mild AS(n=6) , moderate AS(n=17) and severe AS(n=12). Echocardiographic and clinical data of the mild/moderate and severe patients were retrospectively analyzed. Results A total of 120 BAV patients were included, 75 males and 45 females. There was no significant difference in the age between males and females [(mean ages were (51.11±15.46) years and (55.84±13.81) years, respectively, t=-1.69, P>0.05]. Among them, only 19 patients (15.8%) were comfirmed as BAV without related complications, while 35 cases (29.2%) were identified with aortic stenosis (AS), 16 (13.3%) with aortic regurgitation (AR) and 20 (16.7%) with more than one complication. Patients with AR [mean age were (46.44±15.28)years] were younger than those with AS [mean age were (60.17±13.54) years] (t=-3.23, P<0.05). Seventy-five percent (9/12) of the patients with severe AS received operation including tranditional surgery (8 cases) and transcatheter aortic valve implantation (TAVI). The thickness of interventricular septum (IVS, 1 case) and left ventricular posterior wall (LVPW) in the study objects with severe AS [(12.80±2.20)mm, (11.90±1.97)mm] were thicker than those with mild or moderate AS [(9.96±1.40)mm, (9.30±1.02)mm](t=-4.49, Z=-3.39, all P<0.05). Conclusions The proportion of BAV patients with complications is high. Those with serious complications require surgical or cardiac interventional treatment. Echocardiography plays an important role in BAV monitoring. Key words: Bicuspid aortic valve; Echocardiography; Aortic stenosis; Transcatheter aortic valve implantation