Characteristics of aortic valve dysfunction and ascending aorta dimensions according to bicuspid aortic valve morphology.

OBJECTIVE

To characterize aortic valve dysfunction and ascending aorta dimensions according to bicuspid aortic valve (BAV) morphology using computed tomography (CT) and surgical findings.

METHODS

We retrospectively enrolled 209 patients with BAVs who underwent transthoracic echocardiography (TTE) and CT. BAVs were classified as anterior-posterior (BAV-AP) or lateral (BAV-LA) orientation of the cusps and divided according to the presence (raphe+) or absence (raphe-) of a raphe. Ascending aortic dimensions were measured by CT at four levels.

RESULTS

BAV-AP was present in 129 patients (61.7%) and raphe+ in 120 (57.4%). Sixty-nine patients (33.0%) had aortic regurgitation (AR), 70 (33.5%) had aortic stenosis (AS), and 58 (27.8%) had combined AS and AR. AR was more common in patients with BAV-AP and raphe+; AS was more common with BAV-LA and raphe-.Annulus/body surface area and tubular portion/body surface area diameters in patients with BAV-AP (17.1 ± 2.3 mm/m(2) and 24.2 ± 5.3 mm/m(2), respectively) and raphe+ (17.3 ± 2.2 mm/m(2) and 24.2 ± 5.5 mm/m(2), respectively) were significantly different from those with BAV-LA (15.8 ± 1.9 mm/m(2) and 26.4 ± 5.5 mm/m(2), respectively) and raphe- (15.7 ± 1.9 mm/m(2) and 26.2 ± 5.4 mm/m(2), respectively).

CONCLUSION

The morphological characteristics of BAV might be associated with the type of valvular dysfunction, and degree and location of an ascending aorta dilatation.

KEY POINTS: • The BAV-AP type had more frequent aortic regurgitation, raphe, and a larger aortic annulus. • BAV without raphe had more frequent aortic stenosis and mid-ascending aorta dilatation. • CT allows assessment of the morphological characteristics of BAV and associated aortopathy.