Dilatation of the entire thoracic aorta in patients with bicuspid aortic valve: a magnetic resonance angiography study.
BACKGROUND
The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated.


METHODS
Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 +/- 9 years).


RESULTS
Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 +/- 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 +/- 10 years). In the BAV-patients, aortic root diameter was 35.1 +/- 4.9 mm versus 28.9 +/- 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 +/-5.6 mm versus 27.0 +/- 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 +/- 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 +/- 4.8 mm versus 27.0 +/- 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 +/- 5.6 mm versus 21.5 +/- 1.8 mm, p < 0.01) and descending aorta (21.8 +/- 5.6 mm versus 17.0 +/- 5.6 mm, p < 0.01).


CONCLUSIONS
The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.
Westhoff-Bleck
M
M
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. Westhoff-Bleck.Mechthild@mh-hannover.de
Meyer
G P
GP
Lotz
J
J
Tutarel
O
O
Weiss
T
T
Rafflenbeul
W
W
Drexler
H
H
Schröder
E
E
D000328:Adult; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000175:diagnosis* / Q000209:etiology; D001021:Aortic Valve / Q000002:abnormalities* / Q000473:pathology*; D004108:Dilatation, Pathologic / Q000473:pathology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity