Dilatation of the ascending aorta in bicuspid aortic valve disease: a magnetic resonance imaging study.
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.
Debl
Kurt
K
Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, F.J.-Strauss-Allee 11, 93042 Regensburg, Germany. kurt.debl@klinik.uni-regensburg.de
Djavidani
Behrus
B
Buchner
Stefan
S
Poschenrieder
Florian
F
Schmid
Franz-Xaver
FX
Kobuch
Reinhard
R
Feuerbach
Stefan
S
Riegger
Günter
G
Luchner
Andreas
A
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