Evaluation of Ascending Aortic Dilation in Patients with Functionally Normal and Stenotic Bicuspid Aortic Valves by Echocardiography

Objective To determine whether the ascending aortic dilation associated with a bicuspid aortic valve occurs independently of valvular hemodynamic abnormality. Methods Aortic dimensions were measured by two echocardiography in 79 subjects with a functionally normal ( n =42) or stenotic ( n =37) bicuspid aortic valve and compared with the findings in 40 normal subjects matched for age, body surface area and artery pressure. Ascending aortic measurements were made at four levels: annulus, sinuses of Valsalva, supra aortic ridge, and proximal ascending aorta. Results The dimensions of the ascending aorta in subjects with a bicuspid aortic valve were larger than in controls at three levels:sinuses of Valsalva, supra aortic ridge, and proximal ascending aorta ( P 0.05 to P 0.001). There were 18 subjects had ascending aortic dimensions comparable with controls, while 24 had definitely abnormal ascending aortic dimensions in 42 subjects with a functionally normal bicuspid aortic valve. Conclusion There was a high prevalence of ascending aortic dilatation in patients with bicuspid aortic valve. These findings support the hypothesis that bicuspid aortic valve and ascending aortic dilation may reflect a common developmental defect.