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Aortic Valve Disease

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Valvular Heart Disease in Clinical Practice

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Abstract

The aortic valve is a passive valve made up of three leaflets which assume the shape of half moons (semi-lunar). Opposite to the mitral valve there is no true aortic fibrous annulus but a complex root made up of the aortic wall sinuses, left ventricular myocardium and interleaflet fibrous triangles. The ostia of the coronary arteries are located within the aortic sinuses. The sino-tubular junction is an important anatomic landmark for surgical procedures. It may be that the leaflets of the aortic valve are not passive as they are rich in different types of nerve endings. The function and role of these ‘nerves’ remain obscure.

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References

  1. Levine RA, Cape EG, Yoganathan AP. Pressure recovery distal to stenoses: expanding clinical applications of engineering principles. J Am Coll Cardiol 1993; 21(4):1026–1028.

    Article  CAS  PubMed  Google Scholar 

  2. Zoghbi WA, Farmer KL, Soto JG, et al. Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography. Circulation 1986; 73(3):452–459.

    CAS  PubMed  Google Scholar 

  3. Otto CM, Burwash IG, Legget ME, et al. Prospective study of asymptomatic valvular aortic stenosis: clinical, echocardiographic, and exercise predictors of outcome. Circulation 1997; 95(9):2262–2270.

    CAS  PubMed  Google Scholar 

  4. Rajappan K, Rimoldi OE, Dutka DP, et al. Mechanisms of coronary microcirculatory dysfunction in patients with aortic stenosis and angiographically normal coronary arteries. Circulation 2002; 105(4):470–476.

    Article  PubMed  Google Scholar 

  5. Petropoulakis PN, Kyriakidis MK, Tentolouris CA, et al. Changes in phasic coronary blood flow velocity profile in relation to changes in hemodynamic parameters during stress in patients with aortic valve stenosis. Circulation 1995; 92(6):1437–1447.

    CAS  PubMed  Google Scholar 

  6. Hildick-Smith DJ, Shapiro LM. Coronary flow reserve improves after aortic valve replacement for aortic stenosis: an adenosine transthoracic echocardiography study. J Am Coll Cardiol 2000; 36(6):1889–1896.

    Article  CAS  PubMed  Google Scholar 

  7. Beppu S, Suzuki S, Matsuda H, Ohmori F, Nagata S, Miyatake K. Rapidity of progression of aortic stenosis in patients with congenital bicuspid aortic valves. Am J Cardiol 1993; 71(4):322–327.

    Article  CAS  PubMed  Google Scholar 

  8. Pachulski RT, Chan KL. Progression of aortic valve dysfunction in 51 adult patients with congenital bicuspid aortic valve: assessment and follow up by Doppler echocardiography. Br Heart J 1993; 69(3):237–240.

    Article  CAS  PubMed  Google Scholar 

  9. Hahn RT, Roman MJ, Mogtader AH, Devereux RB. Association of aortic dilation with regurgitant, stenotic and functionally normal bicuspid aortic valves. J Am Coll Cardiol 1992; 19(2):283–288.

    Article  CAS  PubMed  Google Scholar 

  10. Gewillig M, Daenen W, Dumoulin M, Van der HL. Rheologic genesis of discrete subvalvular aortic stenosis: a Doppler echocardiographic study. J Am Coll Cardiol 1992; 19(4): 818–824.

    Article  CAS  PubMed  Google Scholar 

  11. Borow KM, Glagov S. Discrete subvalvular aortic stenosis: is the presence of upstream complex blood flow disturbances an important pathogenic factor? J Am Coll Cardiol 1992; 19(4):825–827.

    Article  CAS  PubMed  Google Scholar 

  12. Henein MY, O'Sullivan C, Sutton GC, Gibson DG, Coats AJ. Stress-induced left ventricular outflow tract obstruction: a potential cause of dyspnea in the elderly. J Am Coll Cardiol 1997; 30(5):1301–1307.

    Article  CAS  PubMed  Google Scholar 

  13. Nasrallah AT, Nihill M. Supravalvular aortic stenosis: echocardiographic features. Br Heart J 1975; 37(6):662–667.

    Article  CAS  PubMed  Google Scholar 

  14. Usher BW, Goulden D, Murgo JP. Echocardiographic detection of supravalvular aortic stenosis. Circulation 1974; 49(6):1257–1259.

    CAS  PubMed  Google Scholar 

  15. Weyman AE, Caldwell RL, Hurwitz RA, Girod DA, Dillon JC, Feigenbaum H, et al. Cross-sectional echocardiographic characterization of aortic obstruction. 1. Supravalvular aortic stenosis and aortic hypoplasia. Circulation 1978; 57(3): 491–497.

    CAS  PubMed  Google Scholar 

  16. Lindroos M, Kupari M, Heikkila J, Tilvis R. Prevalence of aortic valve abnormalities in the elderly: an echocardiographic study of a random population sample. J Am Coll Cardiol 1993; 21(5):1220–1225.

    Article  CAS  PubMed  Google Scholar 

  17. Brandenburg RO, Jr., Tajik AJ, Edwards WD, Reeder GS, Shub C, Seward JB. Accuracy of 2-dimensional echocardiographic diagnosis of congenitally bicuspid aortic valve: echocardiographic-anatomic correlation in 115 patients. Am J Cardiol 1983; 51(9):1469–1473.

    Article  PubMed  Google Scholar 

  18. Panidis IP, Segal BL. Aortic valve disease in the elderly. In: Frankl WS, Brest AN, editors. Valvular Heart Disease: Comprehensive Evaluation and Management. Philadelphia, PA.: F.A. Davis, 1985; 289–311.

    Google Scholar 

  19. DePace NL, Nestico PF, Kotler MN, Mintz GS, Kimbiris D, Goel IP, et al. Comparison of echocardiography and angiography in determining the cause of severe aortic regurgitation. Br Heart J 1984; 51(1):36–45.

    Article  CAS  PubMed  Google Scholar 

  20. Collinson J, Flather M, Pepper JR, Gibson DG, Henein M. Reversal of ventricular dysfunction and subendocardial ischaemia following aortic valve replacement in patients with severe aortic stenosis. Circulation 2000; 102(18):11–661.

    Google Scholar 

  21. Imaizumi T, Orita Y, Koiwaya Y, Hirata T, Nakamura M. Utility of two-dimensional echocardiography in the differential diagnosis of the etiology of aortic regurgitation. Am Heart J 1982; 103(5):887–896.

    Article  CAS  PubMed  Google Scholar 

  22. Bonner AJ, Jr., Sacks HN, Tavel ME. Assessing the severity of aortic stenosis by phonocardiography and external carotid pulse recordings. Circulation 1973; 48(2):247–252.

    PubMed  Google Scholar 

  23. Gibson DG. Valve disease. In: Weatherall DJ, editor. Oxford Textbook of Medicine. Oxford Medical Publications, 1996; 2451.

    Google Scholar 

  24. Chang S, Clements S, Chang J. Aortic stenosis: echocardiographic cusp separation and surgical description of aortic valve in 22 patients. Am J Cardiol 1977; 39(4):499–504.

    Article  CAS  PubMed  Google Scholar 

  25. Lesbre JP, Scheuble C, Kalisa A, Lalau JD, Andrejak MT. Echocardiography in the diagnosis of severe aortic valve stenosis in adults. Arch Mal Coeur Vaiss 1983; 76(1):1–12.

    CAS  PubMed  Google Scholar 

  26. Williams DE, Sahn DJ, Friedman WF. Cross-sectional echocardiographic localization of sites of left ventricular outflow tract obstruction. Am J Cardiol 1976; 37(2): 250–255.

    Article  CAS  PubMed  Google Scholar 

  27. Berger M, Berdoff RL, Gallerstein PE, Goldberg E. Evaluation of aortic stenosis by continuous wave Doppler ultrasound. J Am Coll Cardiol 1984; 3(1):150–156.

    Article  CAS  PubMed  Google Scholar 

  28. Currie PJ, Seward JB, Chan KL, Fyfe DA, Hagler DJ, Mair DD, et al. Continuous wave Doppler determination of right ventricular pressure: a simultaneous Doppler-catheterization study in 127 patients. J Am Coll Cardiol 1985; 6(4):750–756.

    Article  CAS  PubMed  Google Scholar 

  29. Hatle L, Angelsen BA. Doppler Ultrasound in Cardiology. 2nd ed. Philadelphia: Lea & Febiger, 1985.

    Google Scholar 

  30. Lima CO, Sahn DJ, Valdes-Cruz LM, Allen HD, Goldberg SJ, Grenadier E, et al. Prediction of the severity of left ventricular outflow tract obstruction by quantitative two-dimensional echocardiographic Doppler studies. Circulation 1983; 68(2):348–354.

    CAS  PubMed  Google Scholar 

  31. Pellikka PA, Nishimura RA, Bailey KR, Tajik AJ. The natural history of adults with asymptomatic, hemodynamically significant aortic stenosis. J Am Coll Cardiol 1990; 15(5):1012–1017.

    Article  CAS  PubMed  Google Scholar 

  32. Kosturakis D, Allen HD, Goldberg SJ, Sahn DJ, Valdes-Cruz LM. Noninvasive quantification of stenotic semilunar valve areas by Doppler echocardiography. J Am Coll Cardiol 1984; 3(5):1256–1262.

    Article  CAS  PubMed  Google Scholar 

  33. Richards KL, Cannon SR, Miller JF, Crawford MH. Calculation of aortic valve area by Doppler echocardiography: a direct application of the continuity equation. Circulation 1986; 73(5):964–969.

    CAS  PubMed  Google Scholar 

  34. Zoghbi WA, Farmer KL, Soto JG, Nelson JG, Quinones MA. Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography. Circulation 1986; 73(3):452–459.

    CAS  PubMed  Google Scholar 

  35. Oh JK, Taliercio CP, Holmes DR, Jr., Reeder GS, Bailey KR, Seward JB, et al. Prediction of the severity of aortic stenosis by Doppler aortic valve area determination: prospective Doppler-catheterization correlation in 100 patients. J Am Coll Cardiol 1988; 11(6):1227–1234.

    Article  CAS  PubMed  Google Scholar 

  36. Bonow RO, Carabello BA, Kanu C, de Leon AC Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O’Gara PT, O’Rourke RA, Otto CM, Shah PM, Shanewise JS, Smith SC Jr, Jacobs AK, Adams CD, Anderson JL, Antman EM, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Lytle BW, Nishimura R, Page RL, Riegel B. ACC/AHA 2006 guideliness for the management of patients with valvular heart diseases: a report of the American College of Cardiology/American Heart Association Task Force on Practise Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 2006; 114:e84–e231.

    Google Scholar 

  37. Monin JL, Monchi M, Gest V, et al. Aortic stenosis with severe left ventricular dysfunction and low transvalvular pressure gradients: risk stratification by low-dose dobutamine echocardiography. J Am Coll Cardiol 2001; 37(8):2101–2107.

    Article  CAS  PubMed  Google Scholar 

  38. Schwammenthal E, Vered Z, Moshkowitz Y, Rabinowitz B, Ziskind Z, Smolinski AK, et al. Dobutamine echocardiography in patients with aortic stenosis and left ventricular dysfunction: predicting outcome as a function of management strategy. Chest 2001; 119(6):1766–1777.

    Article  CAS  PubMed  Google Scholar 

  39. Rosenhek R, Binder T, Porenta G, et al. Predictors of outcome in severe, asymptomatic aortic stenosis. N Engl J Med 2000; 343(9):611–617.

    Article  CAS  PubMed  Google Scholar 

  40. Horstkotte D, Loogen F. The natural history of aortic valve stenosis. Eur Heart J 1988; 9(Suppl E):57–64.

    PubMed  Google Scholar 

  41. Frank S, Johnson A, Ross J, Jr. Natural history of valvular aortic stenosis. Br Heart J 1973; 35(1):41–46.

    Article  CAS  PubMed  Google Scholar 

  42. Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, Bolger A, Cabell CH, Takahashi M, Baltimore RS, Newburger JW, Strom BL, Tani LY, Gerber M, Bonow RO, Pallasch T, Shulman ST, Rowley AH, Burns JC, Ferrieri P, Gardner T, Goff D, Durack DT. American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee; American Heart Association Council on Clinical Cardiology; American GHeaert Association Council on Cardiovascular Surgery and Anesthesia; Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007; 116:1736–1754.

    Google Scholar 

  43. Pohle K, Maffert R, Ropers D, et al. Progression of aortic valve calcification: association with coronary atherosclerosis and cardiovascular risk factors. Circulation 2001; 104(16): 1927–1932.

    Article  CAS  PubMed  Google Scholar 

  44. Fremes SE, Goldman BS, Ivanov J, et al. Valvular surgery in the elderly. Circulation 1989; 80(3 Pt 1)177–190.

    Google Scholar 

  45. Malouf JF, Enriquez-Sarano M, Pellikka PA, et al. Severe pulmonary hypertension in patients with severe aortic valve stenosis: clinical profile and prognostic implications. J Am Coll Cardiol 2002; 40(4):789–795.

    Article  PubMed  Google Scholar 

  46. Buchwald AB, Meyer T, Scholz K, Schorn B, Unterberg C. Efficacy of balloon valvuloplasty in patients with critical aortic stenosis and cardiogenic shock – the role of shock duration. Clin Cardiol 2001; 24(3):214–218.

    Article  CAS  PubMed  Google Scholar 

  47. Blitz LR, Gorman M, Herrmann HC. Results of aortic valve replacement for aortic stenosis with relatively low transvalvular pressure gradients. Am J Cardiol 1998; 81(3): 358–362.

    Article  CAS  PubMed  Google Scholar 

  48. Connolly HM, Oh JK, Orszulak TA, Osborn SL, Roger VL, Hodge DO, et al. Aortic valve replacement for aortic stenosis with severe left ventricular dysfunction: prognostic indicators. Circulation 1997; 95(10):2395–2400.

    CAS  PubMed  Google Scholar 

  49. Connolly HM, Oh JK, Schaff HV, Roger VL, Osborn SL, Hodge DO, et al. Severe aortic stenosis with low transvalvular gradient and severe left ventricular dysfunction:result of aortic valve replacement in 52 patients. Circulation 2000; 101(16):1940–1946.

    CAS  PubMed  Google Scholar 

  50. Pereira JJ, Lauer MS, Bashir M, Afridi I, Blackstone EH, Stewart WJ, et al. Survival after aortic valve replacement for severe aortic stenosis with low transvalvular gradients and severe left ventricular dysfunction. J Am Coll Cardiol 2002; 39(8):1356–1363.

    Article  PubMed  Google Scholar 

  51. Hamamoto M, Bando K, Kobayashi J, Satoh T, Sasako Y, Niwaya K, et al. Durability and outcome of aortic valve replacement with mitral valve repair versus double valve replacement. Ann Thorac Surg 2003; 75(1):28–33.

    Article  PubMed  Google Scholar 

  52. John S, Ravikumar E, John CN, Bashi VV. 25-year experience with 456 combined mitral and aortic valve replacement for rheumatic heart disease. Ann Thorac Surg 2000; 69(4): 1167–1172.

    Article  CAS  PubMed  Google Scholar 

  53. Milano A, Guglielmi C, De Carlo M, Di Gregorio O, Borzoni G, Verunelli F, et al. Valve-related complications in elderly patients with biological and mechanical aortic valves. Ann Thorac Surg 1998; 66(6 Suppl):S82–S87.

    Article  CAS  PubMed  Google Scholar 

  54. Collinson J, Henein M, Flather M, Pepper JR, Gibson DG. Valve replacement for aortic stenosis in patients with poor left ventricular function: comparison of early changes with stented and stentless valves. Circulation 1999; 100(19 Suppl): II1–II5.

    CAS  PubMed  Google Scholar 

  55. Jin XY, Zhang ZM, Gibson DG, Yacoub MH, Pepper JR. Effects of valve substitute on changes in left ventricular function and hypertrophy after aortic valve replacement. Ann Thorac Surg 1996; 62(3):683–690.

    Article  CAS  PubMed  Google Scholar 

  56. Jin XY, Pepper JR, Gibson DG, Yacoub MH. Early changes in the time course of myocardial contraction after correcting aortic regurgitation. Ann Thorac Surg 1999; 67(1): 139–145.

    Article  CAS  PubMed  Google Scholar 

  57. Rajappan K, Melina G, Bellenger NG, Amrani M, Khaghani A, Pennell DJ, et al. Evaluation of left ventricular function and mass after Medtronic Freestyle versus homograft aortic root replacement using cardiovascular magnetic resonance. J Heart Valve Dis 2002; 11(1):60–65.

    PubMed  Google Scholar 

  58. O'Brien MF, Harrocks S, Stafford EG, et al. The homograft aortic valve: a 29-year, 99.3% follow up of 1,022 valve replacements. J Heart Valve Dis 2001; 10(3):334–344.

    PubMed  Google Scholar 

  59. Carr-White GS, Glennan S, Edwards S, Ferdinand FD, Desouza AC, Pepper JR, et al. Pulmonary autograft versus aortic homograft for rereplacement of the aortic valve: results from a subset of a prospective randomized trial. Circulation 1999; 100(19 Suppl):II103–II106.

    CAS  PubMed  Google Scholar 

  60. Grocott-Mason RM, Lund O, Elwidaa H, Mazhar R, Chandrasakeran V, Mitchell AG, et al. Long-term results after aortic valve replacement in patients with congestive heart failure. Homografts vs prosthetic valves. Eur Heart J 2000; 21(20):1698–1707.

    Article  CAS  PubMed  Google Scholar 

  61. Ross DN. Replacement of aortic and mitral valves with a pulmonary autograft. Lancet 1967; 2(7523):956–958.

    Article  CAS  PubMed  Google Scholar 

  62. Oury JH, Doty DB, Oswalt JD, Knapp JF, Mackey SK, Duran CM. Cardiopulmonary response to maximal exercise in young athletes following the Ross procedure. Ann Thorac Surg 1998; 66(6 Suppl):S153–S154.

    Article  CAS  PubMed  Google Scholar 

  63. Porter GF, Skillington PD, Bjorksten AR, Morgan JG, Yapanis AG, Grigg LE. Exercise hemodynamic performance of the pulmonary autograft following the Ross procedure. J Heart Valve Dis 1999; 8(5):516–521.

    CAS  PubMed  Google Scholar 

  64. Morocutti G, Gelsomino S, Spedicato L, Frassani R, Bernardi G, Da Col P, et al. Intraoperative transesophageal echo-Doppler evaluation of stentless aortic xenografts: incidence and significance of moderate gradients. Cardiovasc Surg 2002; 10(4):328–332.

    Article  CAS  PubMed  Google Scholar 

  65. Sousa RC, Garcia-Fernandez MA, Moreno M, Tizon M, Valdeviesos M, Rubio M, et al. The contribution and usefulness of routine intraoperative transesophageal echocardiography in cardiac surgery. An analysis of 130 consecutive cases. Rev Port Cardiol 1995; 14(1):15–27.

    CAS  PubMed  Google Scholar 

  66. Oh JK, Hatle LK, Mulvagh SL, Tajik AJ. Transient constrictive pericarditis: diagnosis by two-dimensional Doppler echocardiography. Mayo Clin Proc 1993; 68:1158–1164.

    Google Scholar 

  67. Lund O, Nielsen TT, Pilegaard HK, et al. The influence of coronary artery disease and bypass grafting on early and late survival after valve replacement for aortic stenosis. J Thorac Cardiovasc Surg 1990; 100(3):327–337.

    CAS  PubMed  Google Scholar 

  68. Lorell BH, Grossman W. Cardiac hypertrophy: the consequences for diastole. J Am Coll Cardiol 1987; 9(5):1189–1193.

    Article  CAS  PubMed  Google Scholar 

  69. Aurigemma G, Battista S, Orsinelli D, et al. Abnormal left ventricular intracavitary flow acceleration in patients undergoing aortic valve replacement for aortic stenosis: a marker for high postoperative morbidity and mortality. Circulation 1992; 86(3):926–936.

    CAS  PubMed  Google Scholar 

  70. Monin JL, Monchi M, Kirsch ME, Petit-Eisenmann H, Baleynaud S, Chauvel C, Metz D, Adams C, Quere JP, Gueret P, Tribouilloy C. Low-gradient aortic stenosis: impact of prosthesis-patient mismatch on survival. Eur Heart J 2007 November; 28(21):2620–2626.

    Google Scholar 

  71. Kvidal P, Bergstrom R, Horte LG, et al. Observed and relative survival after aortic valve replacement. J Am Coll Cardiol 2000; 35(3):747–756.

    Article  CAS  PubMed  Google Scholar 

  72. Allen WM, Matloff JM, Fishbein MC. Myxoid degeneration of the aortic valve and isolated severe aortic regurgitation. Am J Cardiol 1985; 55(4):439–444.

    Article  CAS  PubMed  Google Scholar 

  73. Lau JK, Robles A, Cherian A, Ross DN. Surgical treatment of prosthetic endocarditis: aortic root replacement using a homograft. J Thorac Cardiovasc Surg 1984 May; 87(5): 712–716.

    Google Scholar 

  74. Botvinick EH, Schiller NB, Wickramasekaran R, Klausner SC, Gertz E. Echocardiographic demonstration of early mitral valve closure in severe aortic insufficiency: its clinical implications. Circulation 1975; 51(5):836–847.

    CAS  PubMed  Google Scholar 

  75. Enriquez-Sarano M, Seward JB, Bailey KR, Tajik AJ. Effective regurgitant orifice area: a noninvasive Doppler development of an old hemodynamic concept. J Am Coll Cardiol 1994; 23(2):443–451.

    Article  CAS  PubMed  Google Scholar 

  76. Henry WL, Bonow RO, Rosing DR, Epstein SE. Observations on the optimum time for operative intervention for aortic regurgitation. II. Serial echocardiographic evaluation of asymptomatic patients. Circulation 1980; 61(3):484–492.

    CAS  PubMed  Google Scholar 

  77. Chaliki HP, Mohty D, Avierinos JF, Scott CG, Schaff HV, Tajik AJ, Enriquez-Sarano M. Outcomes after aortic valve replacement in patients with severe aortic regurgitation and markedly reduced left ventricular function. Circulation 2002; 106:2687–2693.

    Google Scholar 

  78. Robertson WS, Stewart J, Armstrong WF, Dillon JC, Feigenbaum H. Reverse doming of the anterior mitral leaflet with severe aortic regurgitation. J Am Coll Cardiol 1984; 3(2 Pt 1):431–436.

    Article  CAS  PubMed  Google Scholar 

  79. Esper RJ. Detection of mild aortic regurgitation by range-gated pulsed Doppler echocardiograhy. Am J Cardiol 1982; 50(5):1037–1043.

    Article  CAS  PubMed  Google Scholar 

  80. Ciobanu M, Abbasi AS, Allen M, Hermer A, Spellberg R. Pulsed Doppler echocardiography in the diagnosis and estimation of severity of aortic insufficiency. Am J Cardiol 1982; 49(2):339–343.

    Article  CAS  PubMed  Google Scholar 

  81. Tribouilloy C, Shen WF, Slama M, Rey JL, Dufosse H, Choquet D, et al. Assessment of severity of aortic regurgitation by M-mode colour Doppler flow imaging. Eur Heart J 1991; 12(3):352–356.

    CAS  PubMed  Google Scholar 

  82. Beyer RW, Ramirez M, Josephson MA, Shah PM. Correlation of continuous-wave Doppler assessment of chronic aortic regurgitation with hemodynamics and angiography. Am J Cardiol 1987; 60(10):852–856.

    Article  CAS  PubMed  Google Scholar 

  83. Labovitz AJ, Ferrara RP, Kern MJ, Bryg RJ, Mrosek DG, Williams GA. Quantitative evaluation of aortic insufficiency by continuous wave Doppler echocardiography. J Am Coll Cardiol 1986; 8(6):1341–1347.

    Article  CAS  PubMed  Google Scholar 

  84. Masuyama T, Kodama K, Kitabatake A, Nanto S, Sato H, Uematsu M, et al. Noninvasive evaluation of aortic regurgitation by continuous-wave Doppler echocardiography. Circulation 1986; 73(3):460–466.

    CAS  PubMed  Google Scholar 

  85. Masuyama T, Kitabatake A, Kodama K, Uematsu M, Nakatani S, Kamada T. Semiquantitative evaluation of aortic regurgitation by Doppler echocardiography: effects of associated mitral stenosis. Am Heart J 1989; 117(1):133–139.

    Article  CAS  PubMed  Google Scholar 

  86. Hoffmann A, Pfisterer M, Stulz P, Schmitt HE, Burkart F, Burckhardt D. Non-invasive grading of aortic regurgitation by Doppler ultrasonography. Br Heart J 1986; 55(3): 283–285.

    Article  CAS  PubMed  Google Scholar 

  87. Quinones MA, Young JB, Waggoner AD, Ostojic MC, Ribeiro LG, Miller RR. Assessment of pulsed Doppler echocardiography in detection and quantification of aortic and mitral regurgitation. Br Heart J 1980; 44(6):612–620.

    Article  CAS  PubMed  Google Scholar 

  88. Enriquez-Sarano M, Seward JB, Bailey KR, Tajik AJ. Effective regurgitant orifice area: a non-invasive Doppler development of an old hemodynamic concent. J Am Coll Cardiol 1994; 23(2):443–451.

    Article  CAS  PubMed  Google Scholar 

  89. Kitabatake A, Ito H, Inoue M, Tanouchi J, Ishihara K, Morita T, et al. A new approach to noninvasive evaluation of aortic regurgitant fraction by two-dimensional Doppler echocardiography. Circulation 1985; 72(3):523–529.

    CAS  PubMed  Google Scholar 

  90. Reimold SC, Ganz P, Bittl JA, Thomas JD, Thoreau D, Plappert TJ, et al. Effective aortic regurgitant orifice area: description of a method based on the conservation of mass. J Am Coll Cardiol 1991; 18(3):761–768.

    Article  CAS  PubMed  Google Scholar 

  91. Zhang Y, Nitter-Hauge S, Ihlen H, Rootwelt K, Myhre E. Measurement of aortic regurgitation by Doppler echocardiography. Br Heart J 1986; 55(1):32–38.

    Article  CAS  PubMed  Google Scholar 

  92. Borer JS, Hochreiter C, Herrold EM, et al. Prediction of indications for valve replacement among asymptomatic or minimally symptomatic patients with chronic aortic regurgitation and normal left ventricular performance. Circulation 1998; 97(6):525–534.

    CAS  PubMed  Google Scholar 

  93. Dujardin KS, Enriquez-Sarano M, Schaff HV, Bailey Kr, Seward Jb, Tajik AJ. Mortality and morbidity of aortic reguagitation in clinical practice: a long-term follow-up study. Circulation 1999; 99:1851–1857.

    Google Scholar 

  94. Edwards WD, Leaf DS, Edwards JE. Dissecting aortic aneurysm associated with congenital bicuspid aortic valve. Circulation 1978; 57(5):1022–1025.

    CAS  PubMed  Google Scholar 

  95. Marsalese DL, Moodie DS, Vacante M, et al. Marfan's syndrome: natural history and long-term follow-up of cardiovascular involvement. J Am Coll Cardiol 1989; 14(2):422–428.

    Article  CAS  PubMed  Google Scholar 

  96. Shores J, Berger KR, Murphy EA, et al. Progression of aortic dilatation and the benefit of long-term beta-adrenergic blockade in Marfan's syndrome. N Engl J Med 1994; 330(19): 1335–1341.

    Article  CAS  PubMed  Google Scholar 

  97. Roman MJ, Rosen SE, Kramer-Fox R, et al. Prognostic significance of the pattern of aortic root dilation in the Marfan syndrome. J Am Coll Cardiol 1993; 22(5):1470–1476.

    Article  CAS  PubMed  Google Scholar 

  98. Gott VL, Pyeritz RE, Cameron DE, et al. Composite graft repair of Marfan aneurysm of the ascending aorta: results in 100 patients. Ann Thorac Surg 1991; 52(1):38–44.

    Article  CAS  PubMed  Google Scholar 

  99. Treasure T. Elective replacement of the aortic root in Marfan's syndrome. Br Heart J 1993; 69(2):101–103.

    Article  CAS  PubMed  Google Scholar 

  100. Bolen JL, Alderman EL. Hemodynamic consequences of afterload reduction in patients with chronic aortic regurgitation. Circulation 1976; 53(5):879–883.

    CAS  PubMed  Google Scholar 

  101. Lin M, Chiang HT, Lin SL, et al. Vasodilator therapy in chronic asymptomatic aortic regurgitation: enalapril versus hydralazine therapy. J Am Coll Cardiol 1994; 24(4): 1046–1053.

    Article  CAS  PubMed  Google Scholar 

  102. Scognamiglio R, Rahimtoola SH, Fasoli G, et al. Nifedipine in asymptomatic patients with severe aortic regurgitation and normal left ventricular function. N Engl J Med 1994; 331(11):689–694.

    Article  CAS  PubMed  Google Scholar 

  103. Gaasch WH, Carroll JD, Levine HJ, et al. Chronic aortic regurgitation: prognostic value of left ventricular end-systolic dimension and end-diastolic radius/thickness ratio. J Am Coll Cardiol 1983; 1(3):775–782.

    Article  CAS  PubMed  Google Scholar 

  104. Collinson J, Flather M, Pepper JR, Henein M. Effects of valve replacement on left ventricular function in patients with aortic regurgitation and severe ventricular disease. J Heart Valve Dis 2004 Sep; 13(5):722–728.

    Google Scholar 

  105. Gott VL, Greene PS, Alejo DE, Cameron DE, Naftel DC, Miller DC, et al. Replacement of the aortic root in patients with Marfan's syndrome. N Engl J Med 1999; 340(17): 1307–1313.

    Article  CAS  PubMed  Google Scholar 

  106. Bentall H, De Bono A. A technique for complete replacement of the ascending aorta. Thorax 1968; 23(4):338–339.

    Article  CAS  PubMed  Google Scholar 

  107. David TE, Feindel CM. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg 1992; 103(4):617–621.

    CAS  PubMed  Google Scholar 

  108. Yacoub MH, Gehle P, Chandrasekaran V, Birks EJ, Child A, Radley-Smith R. Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root. J Thorac Cardiovasc Surg 1998; 115(5):1080–1090.

    Article  CAS  PubMed  Google Scholar 

  109. Coady MA, Rizzo JA, Hammond GL, Mandapati D, Darr U, Kopf GS, et al. What is the appropriate size criterion for resection of thoracic aortic aneurysms? J Thorac Cardiovasc Surg 1997; 113(3):476–491.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Umeà University Hospital Heart Centre, Sweden

    Michael Henein MD (Professor and Consultant Cardiologist)

  2. Mayo Clinic Rochester, Mennisota, USA

    Joseph Maalouf MD (Professor of Medicine)

Authors
  1. Michael Henein MD
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  2. Joseph Maalouf MD
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Editors and Affiliations

  1. Umea Heart Centre, Umea University, Sweden

    Michael Y. Henein (Consultant Cardiologist) (Consultant Cardiologist)

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© 2009 Springer-Verlag London Limited

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Henein, M., Maalouf, J. (2009). Aortic Valve Disease. In: Henein, M.Y. (eds) Valvular Heart Disease in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-84800-275-3_2

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  • DOI: https://doi.org/10.1007/978-1-84800-275-3_2

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84800-274-6

  • Online ISBN: 978-1-84800-275-3

  • eBook Packages: MedicineMedicine (R0)

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