Aortic heart defects

The group aortic defects include: failure of the aortic valve (insufficientia valvulae aortae), aortic stenosis (stenosis ostii aortae and combined aortic Vice.
Dissemination. Failure aortic valve takes the second place after the defeat of the mitral (A. N. Volovik, 1955; C. F. Zelenin, 1962). On sectional data B. A. Chernogubov (1950), among acquired valvular heart failure aortic valve was found in 14%, and only 3.7% of it was isolated, 10.3% met in combination with other vices. Isolated aortic stenosis, according to therapists and pediatricians, meets much less often and 1 % among valve defects (G. F. lang, 1958). But the recent works somewhat shaken this opinion. Thus, according to C. X. Vasilenko (1972), aortic stenosis stand-alone or in combination with other vices observed in 16% of all patients with heart disease. Sectional data B. P. Sokolova (1962) also confirm the detection rate aortic stenosis. The author when 780 the autopsy acquired heart defects aortic stenosis was found in 23%.
According to the cardiological Department of the hospital. K. A. St Petersburg, among acquired heart defects isolated aortic valve insufficiency is observed in 10%,the combination of aortic insufficiency with mitral - 8.1%.
In adult patients, the aortic valve insufficiency among men is observed in 3-3,6 times more often, than among women (A. C. Berland, 1948; G. I. Golikov, 1968).
Etiology. The most frequent cause of formation of the aortal valvular disease is rheumatic endocarditis, which is developing or isolated aortic valve insufficiency, or a combination of insufficiency of aortic valve stenosis aortic. Isolated aortic stenosis more often congenital origin.
Aortic defects are formed in the result of the transferred bacterial endocarditis non-rheumatic origin. Rare cause of insufficiency of the aortic valve is closed trauma of a thorax. Specified defect may occur after surgery about aortic stenosis.
Syphilis until recently was one of the frequent reasons of development., failure of the aortic valve in adult patients, of etiological factors aortic heart defects in children it can be deleted.
Pathological anatomy. Aortic valve, usually located at the mouth of the aorta, consists of 3 semilunar valves attached to the fibrous ring. In the middle of the free edge of each of these doors are fibrous cartilage nodules (small knots Arancia). At movement of blood from the aorta to the heart she fills the pockets of all 3 of valve cusps, with shutters are closed to each other and close the lumen of the outlet of the left ventricle. The presence of knots, Arancia provides the density of closing of the valve during diastole. Rheumatic endocarditis inflammatory process affects mainly the basis of connective tissue valve. This process in children, usually occurs in the form of rheumatic valvulitis. With the development of the pathological process deformation of valve cusps, the thickness of their lands, and the seal of the leaflets of the valve, which leads to the violation of closing the valves in diastole and development of the failure of the aortic valve.
Along with this can happen Union free edges of the shutters among themselves, which leads to a narrowing of the valve opening. Rheumatism is possible the combination of these two processes, and develops combined aortic Vice. Children still often seen and "clean" the failure of the aortic valve. With the progression of the process in the affected tissues further development of regenerative changes and can start calcification valves.
Rheumatic heart valve calcification seen in over 14,5% of sick children, and aortic insufficiency in the incidence of calcification takes the second place after the combined mitral valve (M. A. ivanytska and others, 1975).