Granular Media Calcinosis in the Aortic Walls of Patients With Bicuspid and Tricuspid Aortic Valves.
BACKGROUND
Bicuspid aortic valve (BAV), the most frequent congenital cardiac abnormality, is associated with a higher risk for ascending aortic aneurysms and aorta-related complications (ie, dissection and rupture). The aim of this study was to quantify granular media calcinosis (GMC) in the ascending aortic wall of patients with BAV.


METHODS
We analyzed samples of the ascending aorta from patients with BAV (n = 54) and patients with tricuspid aortic valve (TAV) (n = 33) who underwent aortic repair, regarding medial thickness and diameter expansion. Additionally, the convexity and concavity of the samples were stained for GMC and elastin fragmentation.


RESULTS
The quantitative analysis revealed a significantly higher extent of GMC in patients with BAV at the aortic convexity and concavity compared with patients with TAV, independent of aortic diameter. Additionally, GMC increased with enlargement of the aortic diameter in patients with BAV. Furthermore, we found a significantly reduced total medial thickness in patients with BAV compared with patients with TAV.


CONCLUSIONS
Our findings highlight GMC as a prominent feature of bicuspid aortopathy.
Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany. Electronic address: josephina.haunschild@medizin.uni-leipzig.de.
Josephina
J
Haunschild
Department of Cardiology and Pneumology, Heart Center Göttingen, University Medical Center Göttingen, Göttingen, Germany.
Isabel N
IN
Schellinger
Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.
Sandy
S
von Salisch
Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.
Farhad
F
Bakhtiary
Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.
Martin
M
Misfeld
Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.
Friedrich Wilhelm
FW
Mohr
Department of Cardiology and Pneumology, Heart Center Göttingen, University Medical Center Göttingen, Göttingen, Germany.
Uwe
U
Raaz
Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.
Christian D
CD
Etz
D000368:Aged; D001018:Aortic Diseases / Q000209:etiology* / Q000473:pathology; D001021:Aortic Valve / Q000002:abnormalities* / Q000473:pathology; D000082882:Bicuspid Aortic Valve Disease; D002114:Calcinosis / Q000209:etiology* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014261:Tricuspid Valve; D017540:Tunica Media / Q000473:pathology*