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Ann Thorac Surg 2002;74:58-62
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Morphometric analysis of aortic media in patients with bicuspid and tricuspid aortic valve

Matthias Bauer, MDa, Miralem Pasic, MD, PhD*a, Rudolf Meyer, MD, PhDa, Nadine Goetze, MDa, Ulrike Bauer, MDa, Henryk Siniawski, MDa, Roland Hetzer, MD, PhDa

a Deutsches Herzzentrum Berlin, Berlin, Germany

Accepted for publication March 28, 2002.

* Address reprint requests to Dr Pasic, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Berlin D-13353, Germany
e-mail: pasic{at}dhzb.de

Background. Patients with bicuspid aortic valves tend to develop dilatation of the ascending aorta. The aim of this study was to analyze whether or not there is any histologic difference in the aortic media of patients with a bicuspid aortic valve or a tricuspid aortic valve.

Methods. A morphometric analysis of the wall of the ascending aorta was performed in 107 patients with bicuspid aortic valves undergoing aortic valve operations. The thickness of the elastic lamellae of the aortic media and the distances between the elastic lamellae were measured with the use of an image analysis system. The histologic specimens of the ascending aorta from 61 surgical patients with tricuspid aortic valve disease served as a control.

Results. The patients with bicuspid aortic valves had thinner elastic lamellae of the aortic media (2.71 ± 0.23 µm) of the ascending aortic wall than the patients with tricuspid aortic valve disease (2.83 ± 0.23 µm) (p = 0.006). The patients with bicuspid aortic valves also had greater distances between the elastic lamellae (27.21 ± 8.69 µm) of the ascending aortic wall in comparison with the patients with tricuspid aortic valve disease (24.34 ± 5.32 µm) (p = 0.033). There was no difference in the total thickness of the aortic media between the groups (p = 0.62).

Conclusions. Patients with a bicuspid aortic valve had thinner elastic lamellae of the aortic media and greater distances between the elastic lamellae than patients with a tricuspid aortic valve.




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