Fused aortic valve without an elliptical-shaped systolic orifice in patients with severe aortic stenosis: cardiac computed tomography is useful for differentiation between bicuspid aortic valve with raphe and tricuspid aortic valve with commissural fusion

Objective The objective is to determine cardiac computed tomography (CCT) features capable of differentiating between bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) in severe aortic stenosis (AS) patients with fused cusp and without elliptical-shaped systolic orifices. Methods We retro...

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Bibliographic Details
Published in:European radiology 2015-04, Vol.25 (4), p.1208-1217
Main Authors: Bak, So Hyeon, Ko, Sung Min, Song, Meong Gun, Shin, Je Kyoun, Chee, Hyun Kun, Kim, Jun Suk
Format: Article
Language:English
Subjects:
Aortic stenosis
Aortic Valve - abnormalities
Aortic Valve - diagnostic imaging
Aortic Valve Stenosis - diagnostic imaging
Bicuspid Aortic Valve Disease
Calcification
Cardiac
Coronary vessels
Diagnosis, Differential
Diagnostic Radiology
Female
Heart Valve Diseases - diagnostic imaging
Humans
Imaging
Internal Medicine
Interventional Radiology
Male
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Pulmonary arteries
Radiology
Reproducibility of Results
Retrospective Studies
Thoracic surgery
Tomography
Tomography, X-Ray Computed - methods
Tricuspid Valve - diagnostic imaging
Ultrasound
Veins & arteries
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Summary:Objective The objective is to determine cardiac computed tomography (CCT) features capable of differentiating between bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) in severe aortic stenosis (AS) patients with fused cusp and without elliptical-shaped systolic orifices. Methods We retrospectively enrolled 53 patients who had severe AS with fused cusps and without an elliptical-shaped systolic orifice on CCT and who had undergone surgery. CCT features were analyzed using: 1) aortic valve findings including cusp size, cusp area, opening shape, midline calcification, fusion length, calcium volume score, and calcium grade; 2) diameters of ascending and descending aorta, and main pulmonary artery; and 3) rheumatic mitral valve findings. The variables were evaluated using univariate and multivariate logistic regression analyses. Results At surgery, 19 patients had BAV and 34 had TAV. CCT features including uneven cusp size, uneven cusp area, round-shaped systolic orifice, longer cusp fusion, and dilatation of ascending aorta were significantly associated with BAV ( P  
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-014-3494-1