Abstract
The histopathological characteristics of congenital aortic valve malformations in children were investigated. All the native surgically excised aortic valves from 32 pediatric patients suffering from symptomatic aortic valve dysfunction due to congenital aortic valve malformations between January 2003 and December 2005 were studied macroscopically and microscopically. The patients’ medical records were reviewed and the clinical information was extracted. The diagnosis was made by the clinical presentation, preoperative echocardiography, intraoperative examination, and postoperative histopathological study, excluding rheumatic or degenerative aortic valve diseases, infective endocarditis and primary connective tissue disorders, e.g. Marfan syndrome. Among 32 children with congenital aortic valve malformations, the age was ranged from six to 18 years, with a mean of 14.9 years, and there were 27 boys and five girls (male: female = 5.4:1). There were five cases of aortic stenosis (AS, 15.62%), 25 cases of aortic insufficiency (AI, 78.13%) and two cases of AS-AI (6.25%), without other valve diseases. Twenty cases still had other congenital heart diseases: ventricular septal defect (19 cases), patent ductus arteriosus (two cases), double-chambered right ventricle (one case), aneurysm of the right anterior aortic sinus of valsalva (three cases). Histopathological examination indicated that the cusps became thickening with unequal size, irregular shape (coiling and prolapse edge), enhanced hardness, and partly calcification. Microscopic investigation revealed the unsharp structure of valve tissue, fibrosis, myxomatous, reduced collagen fiber, rupture of elastic fibers, different degrees of infiltration of inflammatory cells, secondary calcareous and lipid deposit, and secondary fibrosis. Congenital aortic valve malformations in children involve males more than females, mostly associated with other congenital heart diseases. Aortic insufficiency is more common in children with congenital aortic valve malformations. Histopathologically, the leaflets of aortic valve are mainly myxomatous, thickening with unequal size, irregular shape (coiling and prolapse edge), reduced collagen fiber, rupture of elastic fibers, without small vessel proliferation and inflammatory cell infiltration, fibrosis and calcification rarely seen.
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References
Bartram U, Bartelings M M, Kramer H H, Gittenberger-de Groot A C. Congenital polyvalvular disease: a review. Pediatr Cardiol, 2001, 22(2): 93–101
Schoen F J. Cardiac valves and valvular pathology: update on function, disease, repair, and replacement. Cardiovasc Pathol, 2005, 14(4): 189–194
Fondard O, Detaint D, Lung B, Choqueux C, Adle-Biassette H, Jarraya M, Hvass U, Couetil J P, Henin D, Michel J B, Vahanian A, Jacob M P. Extracellular matrix remodeling in human aortic valve disease: the role of matrix metalloproteinases and their tissue inhibitors. Eur Heart J, 2005, 26(13): 1333–1341
Tayloy P M, Allen S P, Yacoub M H. Phenotypic and functional characterization of interstitial cells from human heart valves, pericardium and skin. J Heart Valve Dis, 2000, 9(1): 150–158
Lewin M B, Otto C M. The bicuspid aortic valve: adverse outcomes from infancy to old age. Circulation, 2005, 111(7): 832–834
Fedak P W M, Verma S, David T E, Leask R L, Weisel R D, Butany J. Clinical and pathophysiological implications of a bicuspid aortic valve. Circulation, 2002, 106(8): 900–904
Huntington K, Hunter A G, Chan K L. A prospective study to assess the frequency of familial clustering of congenital bicuspid aortic valve. J Am Coll Cardiol, 1997, 30(7): 1809–1812
Ward C. Clinical significance of the bicuspid aortic valve. Heart, 2000, 83(1): 81–85
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Translated from Chin J Evid Based Pediatr, 2006, 1(2): 130–133 [译自: 中国循证儿科杂志]
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Huang, P., Wang, H., Li, Y. et al. Histopathological study of congenital aortic valve malformations in 32 children. Front. Med. China 1, 74–78 (2007). https://doi.org/10.1007/s11684-007-0015-5
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DOI: https://doi.org/10.1007/s11684-007-0015-5