The incidence of congenital bicuspid or bileaflet and quadricuspid or quadrileaflet arterial valves in 3,861 donor hearts in the European Homograft Bank.
OBJECTIVE
The incidence of bicuspidity and quadricuspidity of arterial valves in donor hearts has been assessed in the European Homograft Bank.


METHODS
Morphologically unacceptable donor valves for clinical use were assessed for cusp or leaflet malformation, identifying the different valve types. The state of the adjacent valve was also evaluated. Histological evaluations of the corresponding conduits were performed, in order to assess the incidence of media degeneration.


RESULTS
Among 3,861 donor hearts, 39 (1.0%) showed congenital cusp or leaflet malformation of one or both arterial valves, 28 (0.7%) showed bicuspid or bileaflet aortic valves (BCAV), four (0.1%) showed bicuspid or bileaflet pulmonary valves (BCPV), and eight (0.2%) showed quadricuspid or quadrileaflet pulmonary valves (QCPV). Only in one case (0.03%) were both arterial valves bicuspid or bileaflet. Among the bicuspid arterial valves, 27 (84%) were isolated aortic valves, three (9%) were isolated pulmonary valves, and in one case (3%) both the aortic and pulmonary valves were bicuspid or bileaflet.


CONCLUSIONS
The most frequently identified congenital malformation of the arterial valves was aortic bicuspidity, followed by pulmonary quadricuspidity and bicuspidity. If asymptomatic, these were detected during routine echocardiography, or at autopsy. These malformations might be genetically determined, as they are detected more often among different members of the same families, and in those persons of the same gender or blood group. These valves have a predisposition to accelerated calcification, stenosis, endocarditis and dissection of the ascending aorta. Neither quadricuspid/quadrileaflet nor unicuspid/monoleaflet aortic valves were detected in this study.
Jashari
Ramadan
R
European Homograft Bank, International Association, c/o Queen Astrid Military Hospital, Rue Bruynstraat, 1, B-1120 Brussels, Belgium. jasharir@yahoo.com
Van Hoeck
Beatrice
B
Goffin
Yves
Y
Vanderkelen
Alain
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001344:Autopsy; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005060:Europe; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006351:Heart Valves / Q000002:abnormalities*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000002:abnormalities*; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D055815:Young Adult