Which statement about cusp separation in aortic stenosis is correct?

Which statement about cusp separation in aortic stenosis is correct?

• A. Reduced cusp separation
• B. Increased cusp separation
• C. Unchanged cusp separation
• D. Variable cusp separation

Answer: (A)

In aortic stenosis, the valve leaflets become stiff and often calcified, which restricts their motion and prevents full opening during systole. Because of this limited excursion, the distance between the cusps at maximal opening—cusp separation—is reduced. This reduced separation is a characteristic sign of stenotic opening, reflecting a smaller effective orifice area and the higher flow velocity needed to get blood through the narrowed valve. While mild disease may show relatively normal opening and severe disease shows marked limitation, the overall pattern is that stenosis narrows the opening, leading to decreased cusp separation.

In aortic stenosis, the valve leaflets become stiff and often calcified, which restricts their motion and prevents full opening during systole. Because of this limited excursion, the distance between the cusps at maximal opening—cusp separation—is reduced. This reduced separation is a characteristic sign of stenotic opening, reflecting a smaller effective orifice area and the higher flow velocity needed to get blood through the narrowed valve. While mild disease may show relatively normal opening and severe disease shows marked limitation, the overall pattern is that stenosis narrows the opening, leading to decreased cusp separation.