Echo-Cardio Graphical Evaluation of Morphology of Bicuspid Aortic Valve and Associated Cardiac Malformations in Pediatric Patients

Abstract

Introduction: Bicuspid aortic valve (BAV) occurs both as an isolated cardiac lesion and in association with congenital heart defects (CHD). Their aim was to identify the incidence and morphology of BAV in patients with coexisting CHD and complications compare to patients with isolated BAV. Methodology: The echocardiography data base was retrospectively analyzed to identify pediatric and young adult patients (birth to 18 years) who were diagnosed with BAV from 2017 to 2019. The morphology of BAV was determined from the echocardiographic studies before any intervention. Results: Overall, 102 patients with BAV were identi?ed, 48 (47.1%) with isolated BAV and 54 (52.9%) with BAV and coexisting CHD. The incidence of BAV was highest in patients with Ventricular septal defect (29.41%) and patent ductus aorta (22.54%). Most common type of BAV observed was type 1c (N-L; 33.3%) followed by type 1a (L-R; 30.4%). Difference in type of BAV among isolated BAV and BAV with CHD was found to be statistically significant. (p<0.01). In comparison to patients with isolated BAV, patients with BAV and left-sided heart lesions more frequently had noncoronary-left coronary cusp fusion (P=0.404). BAV in patients with right-sided heart lesions was rare, but they more frequently had noncoronary-left fusion (P<.001). Left sided heart lesions, right sided lesions and Shunt lesions VSD, PDA &ASD were frequently associated with type 1c BAV. Complications were also observed most common AS followed by AR. Conclusions: The BAV can occur as isolated form and also in association with congenital heart diseases most commonly with VSD and PDA. We found most frequently type1 BAV in which most common was type1c (N-L) followed by type1a(R-L). The incidence and morphology of cusp fusion in BAV varies with di?erent coexisting types of CHD. However, in childhood no signi?cant di?erence in valvular dysfunction, aortic dilation was noted in patients with BAV and coexisting CHD compared with patients with isolated BAV. Keywords: Bicuspid aortic valve, congenital heart defects