Causes of pure aortic regurgitation in patients having isolated aortic valve replacement at a single US tertiary hospital (1993 to 2005).
BACKGROUND
The causes of aortic regurgitation (AR) severe enough to warrant aortic valve replacement (AVR) have received little attention in the last 20 years.


RESULTS
We analyzed the causes of pure AR in 268 patients > 20 years of age having isolated AVR at Baylor University Medical Center from 1993 to 2005 that was unassociated with mitral stenosis, mitral valve replacement, or a previous operation involving a cardiac valve or ascending aorta. In 122 patients (46%), the AR resulted from a problem with the aortic valve: congenital malformation unassociated with infective endocarditis, 66 patients (54%); infective endocarditis, 46 patients (38%; 15 with bicuspid valves); probable rheumatic heart disease, 8 patients (6%); and miscellaneous, 2 patients (2%). In the other 146 patients (54%), the AR was the consequence of a condition affecting the ascending aorta: dissection, 28 patients (19%); the Marfan syndrome or its forme fruste variety, 15 patients (10%); aortitis, 12 patients (8%), and in the remaining 91 patients (62%), the cause of the AR was not determined. This latter group was the oldest (mean age 66 years), 83 (91%) had hypertension, 26 (29%) had small calcific deposits in the valve cusps, and 46 (51%) had simultaneous coronary artery bypass grafting.


CONCLUSIONS
The causes of pure AR severe enough to warrant isolated AVR are diverse. The most common category in this study was "cause unclear."
Roberts
William Clifford
WC
Department of Pathology, Division of Cardiology, Baylor Heart & Vascular Institute, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX 75246, USA. wc.roberts@baylorhealth.edu
Ko
Jong Mi
JM
Moore
Timothy Richard
TR
Jones
William Hampton
WH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D001021:Aortic Valve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D001025:Aortitis / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004697:Endocarditis, Bacterial / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D006350:Heart Valve Prosthesis / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008382:Marfan Syndrome / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications / Q000473:pathology / Q000503:physiopathology