CT Angiography of the Native Aortic Valve and Paravalvular Disease: From Imaging to Decision-Making.

Cardiac computed tomography angiography (CTA) now serves as a cornerstone modality for the comprehensive anatomic evaluation of native aortic valve and paravalvular disease. By providing high spatial and temporal resolution, overcoming acoustic window limitations, and enabling both multiplanar and three-dimensional reconstructions, CTA allows for a comprehensive morphological and functional assessment. This review summarizes the anatomic foundation and key measurements of the aortic valve, delineates valvular phenotypes-particularly bicuspid morphology-and illustrates the role of CTA in characterizing aortic stenosis, aortic regurgitation, focal lesions, paravalvular complications of infective endocarditis, and aneurysms involving the aortic valve apparatus. By offering detailed anatomical visualization and clinically relevant metrics, CTA supports accurate diagnosis, improves disease classification, and guides personalized surgical or interventional approaches.