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(Circulation. 1973;48:1140.)
© 1973 American Heart Association, Inc.

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Bicuspid Aortic Valve

Comparison of Congenital and Acquired Types

BRUCE F. WALLER M.D.¹; JOHN B. CARTER M.D.¹; HUGH J. WILLIAMS Jr. ¹; KYUHYUN WANG M.D.¹; JESSE E. EDWARDS M.D.¹

¹ From the Department of Pathology, United Hospitals-Miller Division, St. Paul, Minnesota and the Departments of Pathology and Medicine, University of Minnesota, Minneapolis, Minnesota.

Two dominant types of congenital bicuspid valves are described. The classical type is characterized by the presence of a low ridge or raphe along the aortic aspect of the conjoined cusp. The other is characterized by a tall raphe, the upper edge of which corresponds with the upper level of the aortic cusps. Some such ridges may result from acquired fusion of the adjacent halves of two cusps (yielding an acquired bicuspid valve). In other cases, the ridge is a protrusion of the aorta and not derived from fused cuspid tissue. Such valves are considered to portray a condition which may be termed pseudoacquired congenital bicuspid aortic valve. The acquired bicuspid valve in some cases is compounded of this congenital process and acquired fusion of cuspid tissue. The ratio of classical congenital bicuspid to pseudoacquired congenital bicuspid aortic valve is 4 to 1. Exceptional forms of pseudoacquired congenital bicuspid aortic valves are also described.

Key Words: Congenital bicuspid aortic valve • Acquired bicuspid aortic valve • Commissures of aortic valve