Echocardiographic Morphological Classification of Aortic Stenosis in Sulaimani Pediatric Teaching Hospital/Kurdistan/Iraq

Abstract = 513 times | PDF = 474 times

Main Article Content

Aso Faeq Salih


Aortic stenosis occurs when the heart's aortic valve narrows. This narrowing prevents the valve from opening fully, which obstructs blood flow from the heart into the aorta and onward to the rest of the body. The aim of the study was to performed the echocardiographic study of the major morphological types of aortic valve stenosis in the pediatric cardiac unit in suliamani. A retrospective study including 127 patients aged from birth to 14 years done in the cardiac unit / Sulaimani pediatric teaching hospital. The data were collected from the recorded files of the patients examined in that unit during the period from 2006 to 2016.Collected data included name, age, sex, residency, consanguinity, clinical presentation, associated syndromes and Echo findings.  Statistical analysis was performed by SPSS 21. Chi-square test was used to find out the correlation between categorical variables, P value of (≤ 0.05) was regarded significant. Overall, 80 were males (63%) and 47 were females (37%). Forty patients (31.5%) were below one year. The valvular type found in 96 cases (75.6%). subvalvular and supravalvular types found in 22 cases (17.3%), 9 cases (7.1%) respectively. We found 91 cases (94.8%) of bicuspid, 3 cases (3.1) of tricuspid and 2 cases (2.1%) of the unicuspid valve. In subvalvular type we found 14 cases (63.6%) of sub aortic ridge, 5 cases (22.7%) of tunnel type and 3 cases (13.6%) of systolic anterior motion. In supravalvular type we had 7 cases (77.8%) of hourglass and 2 cases (22.2%) of the long segment. Aortic regurgitation was the most common associated cardiac defect. There was a significant association between the types of aortic stenosis and the mild grade of AR; P value <0.05. In conclusion the valvular aortic stenosis was the most common type of aortic stenosis in this study. Bicuspid aortic valve found to be the most common congenital anomaly associated with aortic stenosis. Most of the patients with aortic stenosis were discovered to have an accidental murmur.


Stenosis, Echocardiography, Bicuspid, Valvular, Regurgitation, Congenital.


Download data is not yet available.

Article Details


[1] D. Schneider and J. Moore, H. Allen, D. Driscoll, R. Shaddy, T. Feltes, “Heart Disease in Infants, Children, and Adolescents, 8th edition, Philadelphia, Lippincott Williams & Wilkins, pp. 1023-1040, 2013.
[2] J. Smallhorn, A. Redington, and R. Anderson, “Congenital Anomalies of the Aortic Valve and Left Ventricular Outflow Tract,” Paediatric Cardiology, 3rdedition, Philadelphia, Churchill Livingstone, pp. (917 -918, 2010
[3] C. Detter, T. Fischlein, C. Feldmeier, “Aortic valvotomy for congenital valvular aortic stenosis: A 37-year experience,” Ann Thorac Surg, vol. 71, pp. 1564–71, 2001.
[4] S. Gokalp, F. Oztunc, “Clinically asymptomatic myocardial bridging in a child with familial sub aortic stenosis,” Cardiol Young, vol. 28, pp. 1-3, 2013.
[5] GE. Pieles, V. Ofoe, GJ. Morgan, “Severe Left Main Coronary Artery Stenosis with Abnormal Branching Pattern in a Patient with Mild Supravalvar Aortic Stenosis and Williams-Beuren Syndrome,” Congenital Heart Dis, 2013
[6] SB. Jureidini, CJ. Marino, GK. Singh, “Main coronary artery and coronary ostial stenosis in children: detection by transthoracic color flow and pulsed Doppler echocardiography,” J Am Soc Echocardiograph, vol. 13, pp. 255- 63, 2000.
[7] T. Geva, G. Shiral, P. Frommelt, “Guidelines and Standards for Performance of a Pediatric Echocardiogram: A Report From the Task Force of the Pediatric Council of the American Society of Echocardiography,” J Am Society of Echocardiography, vol. 19, pp. 1413-1430, 2006.
[8] LW. Perry, CA. Neill, C. Ferencz, “Infants with congenital heart disease: Epidemiology of congenital heart disease. The Baltimore-Washington Infant Study 1981–1989, Perspectives in Pediatric Cardiology. 4. New York: Mount Kisco Futura Publishing Co, pp. 33–62. 1993.
[9] KJ. Rothman, DC. Fyler, “Association of congenital heart defects with season and population density,” Teratology, vol. 13, pp. 29–34, 1976.
[10] M. Shakir, “Pattern of congenital heart disease at Ibn-Seena Teaching Hospital- Mosul/Iraq,” Tikrit Medical Journal, vol. 18, pp. 115-120, 2012.
[11] D. Kitchiner, M. Jackson, N. Malaiya, “Incidence and prognosis of obstruction of the left ventricular outflow tract in Liverpool (1960-91).A studyof 313 patients,” Br Heart J, vol. 71, pp. 588-95, 1994.
[12] CW. Liu, B. Hwang, BC. Lee, “Aortic stenosis in children: 19-year experience,” Taipei, vol. 59, pp. 107-113, 1997.
[13] GB. Peckham, JD. Keith, JR. Evans, “Congenital Aortic Stenosis: Some Observations on the Natural History and Clinical Assessment,” Can Med Assoc J, vol. 19; 91, pp. 639–643, 1964.
[14] AG. Eroglu, K. Babaoglu, L. Saltık, “Echocardiographic Follow-Up of Congenital Aortic Valvular Stenosis,” Pediatric Cardiology, vol. 27, pp. 713–719, 2006.
[15] W. Brown, M. Ruzmetov, P. Vijay, “Surgery for Aortic Stenosis in Children: A 40-Year Experience,” The Annals of Thoracic Surgery, vol. 76, pp. 1398–1411, 2003.
[16] WC. Roberts, JM. Ko, “Frequency by decades of unicuspid, bicuspid, and tricuspid aortic valves in adults having isolated aortic valve replacement for aortic stenosis, with or without associated aortic regurgitation,” Circulation, vol. 111, pp. 920–5, 2005.
[17] E. Newfeld, A. Muster, M. Paul, “Discrete subvalvular aortic stenosis in childhood: Study of 51 patients,”The American Journal of Cardiology, vol. 38, pp. 53-61, 1976.
[18] JA. van Son, GK. Danielson, FJ. Puga, “Supravalvular aortic stenosis. Long-term results of surgical treatment,” J Thorac Cardiovasc Surg, vol. 107, pp. 103-114, 1994.
[19] J. Brown, L. Stevens, S. Holly, “Surgical spectrum of aortic stenosis in children. A Thirty-Year Experience with 257 Children,” The Annals of Thoracic Surgery, vol. 45, pp. 393-403, 1988.
[20] G. Chehab, J. Darido, I. El-Rassi, “Supravalvular aortic stenosis with and without coronary lesions in pediatrics,” The Lebanese Medical Journal, vol. 63, pp. 81-86, 2015.
[21] AG. Eroglu, K. Babaoglu, F. Oztunc, “Echocardiographic follow-up of children with supravalvular aortic stenosis,” Pediatric Cardiology, vol. 27, pp. 707–712, 2006.