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Coronary anatomy in Turner syndrome versus patients with isolated bicuspid aortic valves.
- Source :
-
Heart (British Cardiac Society) [Heart] 2019 May; Vol. 105 (9), pp. 701-707. Date of Electronic Publication: 2018 Oct 27. - Publication Year :
- 2019
-
Abstract
- Objective: Variations in coronary anatomy, like absent left main stem and left dominant coronary system, have been described in patients with Turner syndrome (TS) and in patients with bicuspid aortic valves (BAV). It is unknown whether coronary variations in TS are related to BAV and to specific BAV subtypes.<br />Aim: To compare coronary anatomy in patients with TS with/without BAV versus isolated BAV and to study BAV morphology subtypes in these groups.<br />Methods: Coronary anatomy and BAV morphology were studied in 86 patients with TS (20 TS-BAV, 66 TS-tricuspid aortic valve) and 86 patients with isolated BAV (37±13 years vs 42±15 years, respectively) by CT.<br />Results: There was no significant difference in coronary dominance between patients with TS with and without BAV (25% vs 21%, p=0.933). BAVs with fusion of right and left coronary leaflets (RL BAV) without raphe showed a high prevalence of left coronary dominance in both TS-BAV and isolated BAV (both 38%). Absent left main stem was more often seen in TS-BAV as compared with isolated BAV (10% vs 0%). All patients with TS-BAV with absent left main stem had RL BAV without raphe.<br />Conclusion: The equal distribution of left dominance in RL BAV without raphe in TS-BAV and isolated BAV suggests that presence of left dominance is a feature of BAVs without raphe, independent of TS. Both TS and RL BAV without raphe seem independently associated with absent left main stems. Awareness of the higher incidence of particularly absent left main stems is important to avoid complications during hypothermic perfusion.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Adult
Bicuspid Aortic Valve Disease
Computed Tomography Angiography
Coronary Artery Disease epidemiology
Coronary Artery Disease etiology
Echocardiography
Female
Heart Valve Diseases complications
Humans
Incidence
Male
Netherlands epidemiology
Prevalence
Turner Syndrome complications
Aortic Valve abnormalities
Coronary Angiography methods
Coronary Artery Disease diagnosis
Coronary Vessels diagnostic imaging
Heart Valve Diseases diagnosis
Turner Syndrome diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1468-201X
- Volume :
- 105
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Heart (British Cardiac Society)
- Publication Type :
- Academic Journal
- Accession number :
- 30368485
- Full Text :
- https://doi.org/10.1136/heartjnl-2018-313724