Objective: To compare the characteristics of aortic valve dysfunction and ascending aorta dimension in patients with different bicuspid aortic valve (BAV) morphology. Methods: A total of 197 patients who underwent aortic valve replacement between April 2014 and March 2015 and were diagnosed with BAV by pathology were included, and their clinical data were retrospectively analyzed. Patients were divided into raphe(+) group(109 cases) and raphe(-) group(88 cases) according to the presence or absence of raphe, and L-R group(fusion of left and right cusp, 125 cases) and L/R-N group(fusion of left or right and noncoronary cusp, 72 cases) according to fusion type of the cusps. The characteristics of aortic valve dysfunction and ascending aorta dimension in patients with different BAV morphology were compared. Results: (1) Aortic stenosis incidence was lower in raphe(+) group than in raphe(-) group(22.9%(25/109) vs. 69.3%(61/88), P<0.001). Aortic regurgitation incidence was higher in raphe(+) group than in raphe(-) group (61.5%(67/109) vs. 22.7%(20/88), P<0.001). Incidence of type 1 of aortic root dilation was higher in raphe(+) group than in raphe(-) group (23.9%(26/109)vs.10.2%(9/88), P=0.024). (2) Aortic stenosis incidence was lower in L-R group than in L/R-N group(29.6%(37/125) vs. 68.1%(49/72), P<0.001). Aortic regurgitation incidence was higher in L-R group than in L/R-N group (59.2%(74/125) vs. 18.1%(13/72), P<0.001). Incidence of type 3 of aortic root dilation was lower in L-R group than in L/R-N group(10.4%(13/125) vs. 37.5%(27/72), P=0.006). (3) Aortic stenosis incidence was lower in L-R patients than in L/R-N patients(15.1%(13/86)vs. 52.2%(12/23), P=0.001), and aortic regurgitation incidence was higher in L-R patients than in L/R-N patients in raphe(+) group(73.3%(63/86)vs. 17.4%(4/23), P<0.001). Conclusion: There is significant difference in the type of valvular dysfunction and ascending aorta dilatation in patients with different morphological characteristics of BAV.
目的： 比较二叶式主动脉瓣畸形不同病理分型患者瓣膜功能损害和升主动脉扩张情况。 方法： 回顾性分析2014年4月至2015年3月在阜外医院行主动脉瓣置换术且病理学检查证实为二叶式主动脉瓣畸形的197例患者的临床资料。根据主动脉瓣的融合瓣叶有无脊形成，将患者分为有脊组(109例)和无脊组(88例)；根据主动脉瓣的瓣膜融合类型，将患者分为左-右冠瓣融合组(125例)和左或右-无冠瓣融合组(72例)。比较各组之间的瓣膜功能损害和升主动脉扩张情况。 结果： (1)有脊组主动脉瓣狭窄发生率低于无脊型组[22.9%(25/109)比69.3%(61/88), P<0.001]，而主动脉瓣关闭不全发生率高于无脊型组[61.5%(67/109)比22.7%(20/88), P<0.001]。有脊组1型升主动脉扩张发生率高于无脊组[23.9%(26/109)比10.2%(9/88), P＝0.024]。(2)左-右冠瓣融合组主动脉瓣狭窄发生率低于左或右-无冠瓣融合组[29.6%(37/125)比68.1%(49/72), P<0.001]，而主动脉瓣关闭不全发生率高于左或右-无冠瓣融合组[59.2%(74/125)比18.1%(13/72), P<0.001]。左-右冠瓣融合型组3型升主动脉扩张发生率低于左或右-无冠瓣融合组[10.4%(13/125)比37.5%(27/72), P＝0.006]。(3)在有脊组中，左-右冠瓣融合型患者的主动脉瓣狭窄发生率低于左或右-无冠瓣融合型患者[15.1%(13/86)比52.2%(12/23), P＝0.001]，而主动脉瓣关闭不全发生率高于左或右-无冠瓣融合型患者[73.3%(63/86)比17.4%(4/23), P<0.001]。 结论： 二叶式主动脉瓣畸形不同病理分型患者的瓣膜损害和升主动脉扩张类型存在差异。.
Keywords: Aortic valve insufficiency; Aortic valve stenosis; Cardiovascular abnormalities.