Anatomical and Clinical Predictors of Valve Dysfunction and Aortic Dilation in Bicuspid Aortic Valve Disease

The authors studied 852 adults with bicuspid aortic valves.  The prevelance of three morphotypes was tallied.  Relative fusion rates were: RL 72.9%, RN 24.1% and LN 3%.  Additionally, 18.3% had no raphe.  Aortic regurgitation was unrelated to morphotype.  Aortic stenosis was more common in the RN fusion group and in the presence of a raphe.  Seventy-six percent had ascending aortic dilation unrelated to morphotype but associated with valve dysfunction.  Aortic root dilation was present in 34% and was more commonly associated with male sex and aortic regurgitation.