Aortic Valve Flashcards
Aortc valve is also called
Tricuspid valve (three cusps)
Cusps are seperayed by
3 commisures
Supported by fibrous annulus
Normal surface area of aortic valve
03-04cm2
Narrowing of valve is called
Stenosis
Diff bw sclerosis vs Stenosis
Sclerosis
very common
Thickening degeneration and calcification
Wear and tear phenomenon
Normally with ageing
On top of diseased valve
Anatomically abnormal valve
Few patients develope stenosis
Most common anotomically abnormal valve is bicuspid–stenosis
Rheumatic heart disease–degeneratipn and calcification– stenosis
Most important cause of stenosis
Sclerosis (degeneration and calcification)
Pathophtsiology of stenosis
Inflammation
Atherosclerosis
Osteoblastic transformation
What percent of males have aortic stenosis
80%
Degenerative calcification of the aortic cusp on a substrate of
BAV Or rheumatic
Valve myofibroblast diffrentiates into osteoblast by deposition of
Calcium hydroxy apatite
CF
Lv outflow issue
Compensation of heart for aortic stenosis
Concentric left ventricular hypertrophy
Increased gradiant across valve
Increased peak flow velocity
Decrease in valve surface area (stenosis)
What is sever aortic stenosis
40/4/1 rule
Mean transvalvular gradient across the valve is
40 mm hg
Peak flow velocity is>4 m/sec
Valve surface area <1cm2
Common cause of aortic stenosis in young adults
Bicuspid aortic valve (BAV)
Most common congenital valve defect
Bicuspid aortic valve
Autosomal dominant
NOTCH 1/endothelial nitric oxide synthase defect
75%AS/ 20%AR
