title: Morphology of congenital and acquired aortic valve disease by cardiovascular magnetic resonance imaging.
abstract: Echocardiography is the principal non-invasive tool for initial evaluation and longitudinal monitoring of patients with significant valvular heart disease. However echocardiography can be limited by poor acoustic windows, and is dependent on the skill and experience of the sonographer. Cardiovascular magnetic resonance (CMR) can provide a comprehensive non-invasive assessment of valvular morphology, quantification of the severity of valvular dysfunction, determination of its aetiology, assessment of the consequences for the heart from the valve lesion including measurement of ventricular volumes and function, and evaluation of haemodynamic abnormalities. Additional information such as great vessel anatomy and the presence of coronary disease and myocardial scar can also be obtained from CMR. Aortic valve disease can manifest as aortic regurgitation, aortic stenosis or a mixture of both. Structural abnormalities of the valve (congenital or acquired) or disease of the aorta (structurally normal valve) can cause aortic valve disease. This review describes the role of CMR in evaluation of patients with aortic valve diseases, and illustrates the typical and distinguishing morphological features seen on CMR in a range of congenital and some common acquired aortic valve lesions. Although CMR can provide important information about the morphology of aortic valve, its full potential has yet to be realised, and further studies of clinical outcomes are needed before CMR data can be integrated into the management of patients with significant aortic valvular lesions.
authors.affiliation: Department of Cardiology, Middlemore Hospital, Private Bag 933111, Otahuhu, Auckland, New Zealand. Electronic address: JenLi.Looi@middlemore.co.nz.
authors.forename: Jen-Li
authors.initials: JL
authors.lastname: Looi
authors.affiliation: Department of Cardiology, Middlemore Hospital, Private Bag 933111, Otahuhu, Auckland, New Zealand.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Kerr
authors.affiliation: Department of Cardiology, Middlemore Hospital, Private Bag 933111, Otahuhu, Auckland, New Zealand.
authors.forename: Ruvin
authors.initials: R
authors.lastname: Gabriel
mesh_terms: D001021:Aortic Valve / Q000473:pathology; D001024:Aortic Valve Stenosis / Q000473:pathology; D000082882:Bicuspid Aortic Valve Disease; D004452:Echocardiography / Q000379:methods; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000473:pathology; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D012720:Severity of Illness Index
keywords: Aortic regurgitation; Aortic stenosis; Aortic valve; Cardiovascular magnetic resonance