Congenital aortic stenosis due to unicuspid unicommissural aortic valve: a case report

J Cardiothorac Surg. 2018 Jun 7;13(1):61. doi: 10.1186/s13019-018-0755-0.

Abstract

Background: Unicuspid unicommissural aortic valve is an extremely rare congenital anomaly that usually presents in adulthood but can rarely present in infancy. We report a 17-year-old patient with congenital aortic stenosis secondary to unicuspid unicommissural aortic valve that was successfully treated with aortic valve replacement.

Case presentation: The patient was diagnosed with aortic stenosis after a murmur was heard in the newborn nursery and subsequently underwent aortic balloon valvuloplasty 6 weeks after birth. He had been regularly followed up since and underwent numerous cardiac catheterizations, including another aortic balloon valvuloplasty at age 13. During follow-up at age 17, the patient presented with symptomatic severe aortic stenosis and mild left ventricular hypertrophy. Aortic valve replacement was planned since the patient was nearly adult-sized and to reduce the risk of cardiac decompensation. During the operation an unicuspid unicommissural aortic valve was revealed. The patient recovered well post-operatively. He was discharged 5 days after the surgery in good condition and was completely symptom-free at follow-up 6 weeks later.

Conclusions: Unicuspid aortic valve is a rare congenital anomaly that can cause congenital aortic stenosis. It is seldom diagnosed pre-operatively but should be suspected in infants presenting with aortic stenosis.

Keywords: Aortic valve replacement; Case report; Congenital aortic stenosis; Unicuspid aortic valve.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / congenital
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / etiology*
  • Aortic Valve Stenosis / therapy*
  • Balloon Valvuloplasty
  • Bicuspid Aortic Valve Disease
  • Heart Defects, Congenital / complications*
  • Heart Defects, Congenital / diagnosis
  • Heart Defects, Congenital / surgery*
  • Heart Valve Diseases / complications*
  • Heart Valve Diseases / congenital
  • Heart Valve Diseases / diagnosis
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis Implantation
  • Heart Valve Prosthesis*
  • Humans
  • Infant
  • Infant, Newborn
  • Male