scholarly journals Bicuspid Aortic Valve Morphology And Hemodynamics By Same-Day Echocardiography And Cardiac MRI

2022 ◽  
Author(s):  
Jeesoo Lee ◽  
Nadia El Hangouche ◽  
Ashitha Pathrose ◽  
Gilles Soulat ◽  
Alex J. Barker ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aspect Ratio ◽  
Bicuspid Aortic Valve ◽  
Cardiac Mri ◽  
Peak Velocity ◽  
Cine Mri ◽  
4D Flow Mri ◽  
4D Flow ◽  
Flow Mri ◽  
The Impact

Abstract PURPOSE: This study investigated the impact of bicuspid aortic valve (BAV) on valve morphology and motion as well as proximal and aortic hemodynamics using a same-day echocardiography and cardiac MRI. METHODS: Transthoracic echocardiography, two-dimensional cine MRI of the aortic valve, and aortic 4D flow MRI were performed on the same day in 9 normofunctional BAV patients (age=41±12, 3 female), 4 BAV with moderate to severe aortic stenosis (AS) (age=63±5, 1 female), and 36 healthy tricuspid aortic valve controls (age=52±10, 21 female). Valve opening and closing timings and transvalvular peak velocity were measured using B-mode and Doppler echocardiogram, respectively. Valve orifice morphology at fully-opened state was characterized using cine MRI. Ascending aortic (AAo) wall shear stress (WSS) was measured using 4D flow MRI data. RESULTS: Valve motion timings were similar between BAV and controls. BAV was associated with increased orifice aspect ratio (1.44±0.11 vs. 1.10±0.13, P<0.001), transvalvular peak velocity (1.5±0.3 vs. 1.2±0.2 m/s, P<0.001) and maximum AAo WSS (1.62±0.31 vs. 0.91±0.24 Pa, P<0.001). Increased orifice aspect ratio was associated with the increase in transvalvular peak velocity (r=0.80, P < 0.0001) and maximum AAo WSS (r=0.83, P<0.0001). Transvalvular peak velocity was also positively correlated with maximum AAo WSS (r=0.83, P<0.0001). CONCLUSION: A same-day echo and MRI imaging allows for comprehensive assessment of the impact of aortic valve disease on valve function and hemodynamics. In this pilot application to BAV, we found increased orifice aspect ratio may be responsible for increased transvalvular peak velocity and maximum AAo WSS.

scholarly journals Hemodynamic Profiles Before and After Surgery in Bicuspid Aortic Valve Disease—A Systematic Review of the Literature

2021 ◽  
Vol 8 ◽  
Author(s):  
Daniel G. W. Cave ◽  
Hannah Panayiotou ◽  
Malenka M. Bissell
Keyword(s):  
Systematic Review ◽  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Valve Disease ◽  
Flow Patterns ◽  
Valve Disease ◽  
Aortic Dilatation ◽  
4D Flow Mri ◽  
4D Flow ◽  
Flow Mri

Bicuspid aortic valve (BAV) disease presents a unique management challenge both pre- and post-operatively. 4D flow MRI offers multiple tools for the assessment of the thoracic aorta in aortic valve disease. In particular, its assessment of flow patterns and wall shear stress have led to new understandings around the mechanisms of aneurysm development in BAV disease. Novel parameters have now been developed that have the potential to predict pathological aortic dilatation and may help to risk stratify BAV patients in future. This systematic review analyses the current 4D flow MRI literature after aortic valve and/or ascending aortic replacement in bicuspid aortic valve disease. 4D flow MRI has also identified distinct challenges posed by this cohort at the time of valve replacement compared to standard management of tri-leaflet disorders, and may help tailor the type and timing of replacement. Eccentric pathological flow patterns seen after bioprosthetic valve implantation, but not with mechanical prostheses, might be an important future consideration in intervention planning. 4D flow MRI also has promising potential in supporting the development of artificial valve prostheses and aortic conduits with more physiological flow patterns.

scholarly journals Evaluating the disease progression of pediatric bicuspid aortic valve patients using 4D flow MRI data

2016 ◽  
Vol 18 (S1) ◽  
Author(s):  
Michael J Rose ◽  
Kelly B Jarvis ◽  
Alex J Barker ◽  
Susanne Schnell ◽  
Bradley D Allen ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Disease Progression ◽  
Bicuspid Aortic Valve ◽  
4D Flow Mri ◽  
4D Flow ◽  
Flow Mri

Pressure drop mapping using 4D flow MRI in patients with bicuspid aortic valve disease: A novel marker of valvular obstruction

2020 ◽  
Vol 65 ◽  
pp. 175-182 ◽  
Author(s):  
Ali Fatehi Hassanabad ◽  
Fiona Burns ◽  
Michael S. Bristow ◽  
Carmen Lydell ◽  
Andrew G. Howarth ◽  
...  
Keyword(s):  
Pressure Drop ◽  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Valve Disease ◽  
Valve Disease ◽  
4D Flow Mri ◽  
4D Flow ◽  
Flow Mri

Abstract 17989: Evolution of At-risk Aortic Tissue in Patients With Bicuspid Aortic Valve After Valve or Aorta Replacement

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Emilie Bollache ◽  
Paul W Fedak ◽  
Pim van Ooij ◽  
David Guzzardi ◽  
S. Chris Malaisrie ◽  
...  
Keyword(s):  
At Risk ◽  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Tissue ◽  
4D Flow Mri ◽  
4D Flow ◽  
Increased Risk ◽  
Tissue Area ◽  
Flow Mri

Objectives: Bicuspid aortic valve (BAV) is associated with increased risk of aortopathy requiring surgery. However, to date, there is no clear consensus on aortic resection extent. Our objective was to study in BAV patients the evolution of ascending aortic (AA) ‘at-risk’ tissue, as defined by elevated wall shear stress (WSS) estimated using 4D flow MRI acquired at baseline and follow up. Methods: Eighteen BAV patients (49±15yrs) were included who underwent AA repair and MRI before surgery and at follow up (mean duration: 154±250 [7-977] days). For each patient and exam, 3D aortic systolic WSS was estimated from 4D flow MRI and at-risk tissue area was defined as the treatable region with high WSS, when compared to an atlas of physiologically normal values (as previously established in healthy controls). Results: The baseline sinus of Valsava and mid-AA diameters were both 4.5±0.6cm. Eight patients had severe aortic stenosis or regurgitation. Three patients had aortic valve replacement without aortic resection, 8 had AA repair without hemiarch repair, and 7 had AA and hemiarch repair. In the 8 AA repair patients, 3D area of elevated WSS increased at baseline from 25±29% to 52±37% at follow up, when expressed in percentage of the AA tissue remaining after surgery up from graft to the first branch (Figure). Little change in at-risk tissue area was observed in hemiarch repair patients. Conclusions: Our preliminary study demonstrates feasibility of 4D flow MRI to provide data regarding at-risk aortic tissue progression in BAV patients who underwent AA repair. Larger studies in a variety of clinical conditions are warranted to further understand the implications of these findings.

scholarly journals Hemodynamics in bicuspid aortic valve relatives with trileaflet aortic valves compared to normal controls using 4D flow MRI

2014 ◽  
Vol 16 (S1) ◽  
Author(s):  
Susanne Schnell ◽  
Alex J Barker ◽  
Pegah Entezari ◽  
Amir R Honarmand ◽  
SC Malaisrie ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
4D Flow Mri ◽  
4D Flow ◽  
Aortic Valves ◽  
Flow Mri ◽  
Normal Controls

5 Linking 4D flow MRI and molecular data in bicuspid aortic valve aortopathy: Segmental differences across the aortic circumference

2021 ◽  
Author(s):  
Froso Sophocleous ◽  
Estefania de Garate ◽  
Giulia Bigotti ◽  
Maryam Anwar ◽  
Eva Jover Garcia ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Molecular Data ◽  
4D Flow Mri ◽  
4D Flow ◽  
Flow Mri
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