Sievers and Schmidtke classified the pathology of bicuspid aortic valves. The authors are from Universitaetsklinikum Schleswig-Holstein in Luebeck, Germany.
Patient selection: 2 functional aortic cusps
Finding
Type 0
Type 1
Type 2
potential number of cusps
2 (purely bicuspid)
3 (potentially tricuspid)
3
size of cusps
equal
not equal
not equal
number of raphe
0
1
2
number of commissures
2
1 under and 2 fully developed
2 under and 1 fully developed
Type
Reference Structure
Spatial Subcategory
0
free edge of cusps
antero-posterior or lateral
1
orientation of raphe relative to coronary sinuses
L-R, R-N, or N-L
2
orientation of raphe relative to coronary sinuses
L-R/R-N or L-R/N-R
where:
• L = left and R = right coronary sinuses, N = nonsinus
Functional Status
Subcategory
predominant insufficiency
I
predominant stenosis
S
balanced insufficiency and stenosis
B
neither insufficiency nor stenosis
No
nonclassifiable or missing
X
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