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

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. 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. 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. 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.