Etiologies of Hemodynamically Significant Aortic Regurgitation and
Coronary Cusp Bending: Evaluation by Transesophageal Echocardiography
Abstract
Background: While the number of patients with aortic regurgitation (AR)
has been increasing in the aging society, its etiologies remain to be
fully elucidated. Methods: We studied consecutive 126 patients with
chronic moderate or severe AR who underwent TEE. After the study
subjects were divided into 2 groups by the age of 65 years, AR etiology
was examined in each group. Results: In the older group (n = 85), cusp
bending was the most frequent cause of AR (48.2%), and right coronary
cusp (RCC) was the most common (90.2%). In the younger group (n=41),
bicuspid valve was the most frequent cause (36.5%), and cusp bending
was less frequent (16.5%). Multivariate analysis revealed that age was
the only factor associated with cusp bending. Conclusion: Cusp bending
of RCC was the most frequent etiology of AR in the elderly. Because AR
caused by cusp bending has a possibility to be mended by aortic plasty,
it is important to detect it by TEE especially in the older patients.