title: Dilatation of the ascending aorta in bicuspid aortic valve disease: a magnetic resonance imaging study.
abstract: BACKGROUND
  Bicuspid aortic valve disease (BAV) is increasingly recognized as a disease of the entire proximal aorta including both valvular and vascular complications. The aim of our study was to assess the dimensions of the thoracic aorta using MRI in a broad spectrum of BAV and tricuspid aortic valve disease (TAV) and to define the prevalence of the dilatation of the ascending aorta (AA) >or= 4.5 cm in severe BAV disease.
  
  
  RESULTS
  MRI studies were performed on a 1.5 T scanner in a total of 195 consecutive patients with aortic valve disease. Eighty-four aortic valves were classified as BAV and 103 as TAV. In 8 patients, classification of the aortic valve was not possible due to poor image quality. Mean diameters of the AA were significantly greater in BAV compared to TAV (4.39+/-0.85 Vs. 3.55+/-0.47 cm, P<0.0001), whereas no differences were observed in the mean diameters of the aortic arch. Diameters of the descending aorta were slightly smaller in BAV compared to TAV (2.45+/-0.43 Vs. 2.58+/-0.31 cm, P<0.05). In BAV, AA dilatation was independent of the severity of valve dysfunction. In TAV, aortic regurgitation but not stenosis correlated weakly with AA dilatation. Prevalence of AA dilatation >or= 4.5 cm in BAV with severe aortic stenosis and regurgitation was 38% and 41%, respectively.
  
  
  CONCLUSIONS
  Dilatation of the proximal aorta is a frequent finding in BAV and independent of the severity of valve dysfunction. With respect to the high prevalence of AA dilatation >or= 4.5 cm in BAV with severe valve dysfunction, careful assessment of the dimensions of the AA is crucial to identify patients in whom concomitant AA replacement is indicated according to current guidelines.
authors.affiliation: Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, F.J.-Strauss-Allee 11, 93042 Regensburg, Germany. kurt.debl@klinik.uni-regensburg.de
authors.forename: Kurt
authors.initials: K
authors.lastname: Debl
authors.forename: Behrus
authors.initials: B
authors.lastname: Djavidani
authors.forename: Stefan
authors.initials: S
authors.lastname: Buchner
authors.forename: Florian
authors.initials: F
authors.lastname: Poschenrieder
authors.forename: Franz-Xaver
authors.initials: FX
authors.lastname: Schmid
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kobuch
authors.forename: Stefan
authors.initials: S
authors.lastname: Feuerbach
authors.forename: Günter
authors.initials: G
authors.lastname: Riegger
authors.forename: Andreas
authors.initials: A
authors.lastname: Luchner
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000473:pathology*; D001021:Aortic Valve / Q000002:abnormalities*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000473:pathology*; D002302:Cardiac Output; D015331:Cohort Studies; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged