Establishing Standard Dimensions Of Pediatric Aortic Valves: En Route To Successful Aortic Valve Repair In Children
Daniel Cheong, MD1, Leif Lovig, MD1, Miguel A. Mendoza2, Zev Blumenkrantz2, Khanh Nguyen, MD1.
1Maria Fareri Children's Hospital - New York Medical College, Valhalla, NY, USA, 2New York Medical College, Valhalla, NY, USA.
Objectives: Aortic valve repair in adults using echocardiographic measurements of aortic valve coaptation height (CH), effective height (EH), and geometric height (GH) has been well established with reproducible results. To our best knowledge, there are currently no normative data for these parameters to be extrapolated to aortic valve repair in pediatric population.
Methods: A retrospective review of 103 pediatric echocardiograms were reviewed (age range 0 to 18 years). Descriptive and regression analysis were used to analyze the data. Aortic valvular CH and EH were measured, and GH were derived from CH and EH. Ratio scores were created by dividing each of these measures by aortic annulus: CH to annulus (ACH), EH to annulus (AEH), and GH to annulus (AGH). Measurements and ratio scores were indexed to body surface area (BSA).
Results: CH, EH, GH were plotted against BSA and statistically significant positive correlations were demonstrated, 0.30, 0.47, 0.73, respectively (P < 0.05 for all) while ACH, AEH, AGH had minimal but negative correlation with BSA with slopes of -0.07, -0.08, -0.08, respectively (P < 0.05 for all).
Conclusions: Our study demonstrated that CH, EH, and GH correlated well with BSA, allowing for the development of pediatric normative data. Additionally, the data suggests that establishing normal ratios of these measurements may be used to guide aortic valve repair in children.