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Abstract

Background: The angle between the interventricular septum and the anterior aortic wall is shallow and measured at 120 degrees in normal individuals. In patients with LVOT narrowing, aortic valve anomalies, and a subaortic membrane, this angle is more acute. This will change the flow hemodynamics and might lead to the formation or progression of the subaortic membrane. Objectives: This study aims to assess the IVS/Anterior Aortic wall angle in patients with abnormal aortic valves and/or LVOT obstruction and its association with SAM development. Methodology: A one-year prospective observational study (September 2022 to June 2023) at PSCC-Qassim's pediatric cardiology department included echocardiography of pediatric patients with Bicuspid aortic valve, with or without SAM, and/or Coarctation of the aorta (CoA). Patients with VSD, AVSD (Non-intact IVS), and those with single-ventricle pathology were excluded. and analyzed. Demographic and echocardiographic data, including the IVS/Anterior Aortic angle, were recorded. Results: Among 347 cases, 153 formed the control group, while others were categorized based on valve anatomy and SAM presence. No statistically significant differences in the angle were found between groups. A ROC curve indicated an angle of less than 116 degrees, predicting SAM development with 97% sensitivity and 87% specificity. Conclusion: While patients with SAM and/or BAV may exhibit more acute angles, no significant differences were found compared to those with normal anatomy or BAV without SAM. An angle less than 115 degrees warrants vigilance for SAM development.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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