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Ann Thorac Surg 2003;76:338
© 2003 The Society of Thoracic Surgeons

Correspondence

Reply

Matthias Bauer, MDa, Miralem Pasic, MD, PhDa, Roland Hetzer, MD, PhDa

a Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Berlin 13353, Germany

e-mail: mbauer{at}dhzb.de

To the Editor:

We thank Dr Robicsek for his comments on our report [1] describing the differences in morphologic analysis of the aortic media between patients with bicuspid and tricuspid aortic valves. The two main findings of our morphometric study were that the elastic membranes in patients with a bicuspid aortic valve are thinner than those in patients with a tricuspid aortic valve and that the distances between the elastic lamellae increase in both groups with enlarging diameter of the ascending aorta.

As we wrote in this study, its results cannot resolve the question of whether the thinner elastic membranes in patients with a bicuspid aortic valve are caused by altered hemodynamics or by a common developmental defect of the aortic valve and the wall of the ascending aorta. Whether the aortic wall alterations in patients with a bicuspid aortic valve are caused by a congenital defect of the aortic media or are due to the abnormal stress on the aortic wall caused by the malformed valve has long been a matter of discussion. Therefore, we suggested that further hemodynamic studies in combination with ultrastructural analysis of the elastic lamellae of the aortic media and other constituents of the aortic wall are necessary.

We fully agree with Dr Robicsek that an examination of the aortic wall of newborns with a bicuspid aortic valve could also help solve this problem.

References

  1. Bauer M., Pasic M., Meyer R., et al. Morphometric analysis of aortic media in patients with bicuspid and tricuspid aortic valve. Ann Thorac Surg 2002;74:58-62.[Abstract/Free Full Text]




This Article
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Miralem Pasic
Roland Hetzer
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