Diagnostic Accuracy of Echocardiography and Intraoperative Surgical Inspection of the Unicuspid Aortic Valve

The 10 Commandments for Aortic Valve Repair

“…[12][13][14] Especially in young patients unicuspid valves are more frequent than generally believed, simply because the echocardiographic characteristics are often missed. [15][16][17] Quadricuspid valves are frequent in truncus arteriosus and rare in normal cardiac anatomy 18 ; on the other hand, repair approaches are particularly important in truncus, which usually requires surgery at neonatal or infant stage.…”

“…Because the echocardiographic features of the unicuspid valve are not widely recognized, it is frequently diagnosed as bicuspid. [15][16][17] Also surgeons frequently mistake unicuspid for bicuspid anatomy. 30 Irrespective of the repair approach chosen, the surgeon must recognize the unicuspid nature and include a commissural repair in order to achieve adequate function and durability.…”

Echocardiographic assessment of aortic stenosis: a practical guideline from the British Society of Echocardiography

“…The estimated prevalence of UAV is around 0.02% ( 20 ). Transthoracic (TTE) and trans-oesophageal echocardiography (TOE) are both highly specific for the identification of UAV, but are poorly sensitive, with unicuspid valves often mistakenly identified as bicuspid particularly in the presence of marked calcification ( 21 ). Unicuspid valves are a disproportionate contributor to the overall burden of severe aortic stenosis, particularly in young individuals ( 11 , 22 ).…”

Which Aortic Valve Can Be Surgically Reconstructed?

“…4 ). Experience shows that the vast majority of unicuspid aortic valves are misdiagnosed as bicuspid, both by echocardiography [ 56 ] and in the operating room [ 48 ]. Failure to diagnose this morphology correctly may lead to wrong decision-making.…”