Planimetry of BAV in children and determination of EAVA/AAVA in systole

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Planimetry of BAV in children and determination of
EAVA/AAVA in systole
Yadollahi Farsani H., MD*
Background: Bicuspid aortic valve (BAV) is the most common congenital heart disease (CHD)
and the most common anomaly of aortic valve.
Aims of this study are planimetry of aortic valve and determination of effective aortic valve
area (EAVA) for blood egress to anatomic aortic valve area (AAVA) during systole. In this
congenital anomaly, aortic valve have 2 cusps instead of 3 cusps.
Material & Methods: Thirty patients were evaluated. AAVA & EAVA were measured by 2D &
Doppler-echocardiography and continuity equation. All findings were matched and indexed for
body surface area (BSA). This study was done in Tehran Shaheid Rajaei Hospital during 2003-
2004.
Results: Matched mean AAVA was 2.05 Cm2/m2 BSA and matched mean EAVA was 1.41
Cm2/m2 BSA. Maximum aortic valve pressure gradient (AV-PG max) in systole was 56.56 mmHg.
Forty percent of patients had aortic stenos is (AS), of them mild AS was seen in 16.66%. Moderate
AS in 13.34% and intermediate AS in 10% of patients. There was no any case with severe AS.
Conclusion: AS is common in BAV. In a significant number of patients aortic valve didn’t open
completely during systole, and caused AS and murmur. Because of serious and significant
complications of BAV such as bacterial endocarditic, progressive AS and AI, dilatation and
aneurysm of aortic root, and aortic dissection, complete evaluation and follow up studies of any
child with a heart murmur in order to rule out BAV are recommended.