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From unicuspid to quadricuspid: Influence of aortic valve morphology on aortic three‐dimensional hemodynamics
Author(s) -
Entezari Pegah,
Schnell Susanne,
Mahadevia Riti,
Malaisrie Chris,
McCarthy Patrick,
Mendelson Marla,
Collins Jeremy,
Carr James C.,
Markl Michael,
Barker Alex J.
Publication year - 2014
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24498
Subject(s) - bicuspid aortic valve , hemodynamics , cardiology , bicuspid valve , aortic valve , medicine , blood flow , anatomy
Purpose To assess the impact of aortic valve morphology on aortic hemodynamics between normal tricuspid and congenitally anomalous aortic valves ranging from unicuspid to quadricuspid morphology. Materials and Methods Aortic three‐dimensional (3D) blood flow was evaluated by 4D flow MRI in 14 healthy volunteers with normal trileaflet valves and 14 patients with unicuspid (n = 3), bicuspid (n = 9, 3 “true” bicuspid, 3 right–left (RL), 3 right‐noncoronary (RN) leaflet fusion, and quadricuspid aortic valves (n = 2). Data analysis included the co‐registered visualization of aortic valve morphology with systolic 3D blood flow. The influence of valve morphology on aortic hemodynamics was quantified by valve flow angle. Results All RL‐bicuspid aortic valve (BAV) were associated with flow jets directed toward the right anterior aortic wall while RN‐fusion and unicuspid valves resulted in flow jet patterns toward the right‐posterior or posterior wall. Flow angles were clearly influenced by valve morphology (47° ± 10, 28° ± 2, 29° ± 18, 18° ± 12, 15° ± 2 for unicuspid, true BAV, RN‐BAV, RL‐BAV, quadricuspid valves) and increased compared with controls (7.2° ± 1.1, P = 0.001). Conclusion Altered 3D aortic hemodynamics are impacted by the morphology of congenitally malformed aortic valves. J. Magn. Reson. Imaging 2014;40:1342–1346 . © 2013 Wiley Periodicals, Inc .