Klinische Charakteristika verschiedener Aortenklappenmorphologien

For a good twenty years, reconstruction and interventional replacement have been developing into promising new therapy options for aortic valve disease. The type of aortic valve (unicuspid, bicuspid, tricuspid) seems to have an influence on the therapeutic outcome. Determining this type preoperatively can be difficult. Knowledge of the frequencies and clinical appearance of the individual valve types is helpful here. While the common bicuspid aortic valve has been well studied, the data on the rarer valve types is still sparse and possibly subject to uncertainty. Therefore, we wanted to generate as large a data set as possible, which would also ensure maximum accuracy in the assessment of the valve type through intraoperative inspection. In this way, previously published estimates for the more common valve types could be reviewed and refined, and new estimates for the less common valve types could be obtained. All patients who had undergone their first aortic valve surgery by a single surgeon (SCHÄFERS) between 2000 and 2015 were included. The type of valve as well as other clinical aspects (age, gender, type of valve disease) and comorbidities (aneurysm, dissection, coronary artery disease, mitral valve regurgitation, infective endocarditis) were retrospectively recorded on the basis of the operation reports. The data set was analysed using IBM SPSS Statistics 25. Qualitative characteristics were analysed using the Chi² test, quantitative characteristics using the Mann-Whitney U or Kruskal-Wallis test. Furthermore, valve types were compared in pairs using regression analysis and clinically relevant confounding variables were tested. In a sample of 3184 patients, we found non-tricuspid aortic valves in 47.02% of cases: 38.32% bicuspid, 8.42% unicuspid and 0.28% quadricuspid. Due to the small number of cases, the latter were described descriptively and excluded from further analyses. The lower the number of cusps, the younger the patient was at the time of surgery. More patients were male for all three valve ...