title: Assessment of aortic valve in regard to its anatomical variants morphology in 2053 patients using 64-slice CT retrospective coronary angiography.
abstract: BACKGROUND
  Bicuspid aortic valve (BAV) is the most common congenital cardiac anomaly. Other aortic valve variants are rare but are associated with an increased incidence of various pathologies of the aortic valve (AV). The aim of this study was to assess the AV function in regard to its anatomical variants morphology in patients who underwent 64-slice coronary computed tomography angiography (CCTA) for suspected or known coronary artery disease.
  
  
  METHODS
  The results of 64-detector retrospective ECG-gated CCTA of 2053 patients (mean age 58 years; 1265 males) were analyzed retrospectively by experienced cardiovascular radiologist. Coronary anatomy (with coronary artery dominance) and the extent of occlusion in the coronary arteries were assessed. Furthermore morphological and functional status of AV variants were analyzed. Among measured parameters were area at the level of AV annulus, orifice and tubular portion of the ascending aorta.
  
  
  RESULTS
  The AV was visualized in all CCTA studies and the analysis of its morphology and function was done in all patients. BAV was found in 19 patients (0.9 %), from which type 0 was diagnosed in five patients (0.2 %) and type 1 in 14 patients (0.7 %) - there was no patient with BAV type 2. Unicuspid (UAV) and quadricuspid (QAV) variant were both observed each in one patient (0.05 %). In rest of the patients from the study group tricuspid AV variant was recognized. Function of AV variants was mostly affected in BAV0 and UAV. Among patients with BAV1 there were patients with normal and abnormal function of AV. QAV variant did not deteriorate AV function. There was no difference in coronary artery disease and dominancy between different anatomical variants of AV.
  
  
  CONCLUSIONS
  During CCTA different valve variants can be detected and detailed analysis of valvular function can be proceeded. Larger values of annulus area, wider diameters of ascending aorta and more stenotic profile were observed in BAV 0, BAV 1 and UAV. Among AV variants morphology and function was mostly affected in patients with BAV 0 and UAV variants, while subjects with BAV1 had normal or abnormal function of the AV. Moreover, we noticed that QAV variant did not deteriorate AV function.
authors.affiliation: Department of Radiology, Barlicki University Hospital, Medical University of Lodz, ul. Kopcińskiego 22, 90-153, Lodz, Poland.
authors.forename: Konrad
authors.initials: K
authors.lastname: Szymczyk
authors.affiliation: Department of Angiology, Medical University of Lodz, Narutowicza 60, Łódź, 90-136, Poland. michal.polguj@umed.lodz.pl.
authors.forename: Michał
authors.initials: M
authors.lastname: Polguj
authors.affiliation: Department of Radiology, Barlicki University Hospital, Medical University of Lodz, ul. Kopcińskiego 22, 90-153, Lodz, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Szymczyk
authors.affiliation: II Department of Clinical Radiology, Medical University of Warsaw, ul. Banacha 1A, 02-097, Warsaw, Poland.
authors.forename: Leopold
authors.initials: L
authors.lastname: Bakoń
authors.affiliation: II Department of Clinical Radiology, Medical University of Warsaw, ul. Banacha 1A, 02-097, Warsaw, Poland.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Pacho
authors.affiliation: Department of Radiology, Barlicki University Hospital, Medical University of Lodz, ul. Kopcińskiego 22, 90-153, Lodz, Poland.
authors.forename: Ludomir
authors.initials: L
authors.lastname: Stefańczyk
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055424:Cardiac-Gated Imaging Techniques; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D012189:Retrospective Studies
keywords: Bicuspid; Coronary computed tomography angiography; Quadricuspid aortic valve; Unicuspid