背景:主动脉瓣开窗(AVF)似乎相对常见;然而,它们对人类心脏病的影响尚不完全清楚。
方法:进行了综述,以评估与AVF相关的人类患者的所有科学文献,正如已发表的文献中所描述的那样。搜索是在两个不同的数据库上进行的,Medline(PubMed),和ISIWebofKnowledge。
结果:55份报告正在分析中。尸检研究表明,在此类研究中,有55.9%的个体存在AVF。它们更常见于男性,总的来说,他们的频率随着年龄的增长而增加。虽然普通,开窗很少引起反流;然而,它们可能在一些严重主动脉瓣反流病例的病理生理中起重要作用。已经在唐氏综合征和马凡氏综合征患者中描述了AVF,在患有二尖瓣或四尖瓣的患者中,和粘液瘤样瓣膜变性患者。超声心动图评估主动脉瓣反流似乎在诊断瓣膜开窗方面存在局限性。
结论:主动脉瓣的开窗非常常见,并且与某些临床状况有关。尚不清楚AVF是否在当前的主动脉瓣疾病流行中起任何作用。未来的研究应旨在更好地定义AVFs在主动脉瓣疾病中的作用。进一步了解其病因并制定诊断标准。
BACKGROUND: Aortic valve fenestrations (AVFs) seem to be relatively common; however, their impact in human heart disease is not entirely clear.
METHODS: A review was carried out to assess all scientific literature on human patients related to AVFs, as described in the published literature. The search was conducted on 2 different databases, Medline (PubMed), and ISI Web of Knowledge.
RESULTS: Fifty-five reports were under analysis. Autopsy studies showed AVFs to be present in 55.9% of individuals studied in such studies. They occur more frequently in men and, in general, their frequency increases with age. Although common, fenestrations rarely cause regurgitation; however, they may play an important role in the pathophysiology of some cases of severe aortic regurgitation. AVFs have been described in patients with Down syndrome and Marfan syndrome, in patients with bicuspid or quadricuspid valves, and in patients with myxomatous valvular degeneration. Echocardiographic assessment of aortic regurgitation seems to have limitations in the diagnosis of valvular fenestrations.
CONCLUSIONS: Fenestrations of the aortic valve are very common and are associated with certain clinical conditions. It is unknown if AVFs play any role in the current epidemic of aortic valve disease. Future studies should aim to better define the role of AVFs in aortic valve disease, to further understand its etiology and to develop diagnostic criteria.