Current and Future Aspects of Multimodal Imaging, Diagnostic, and Treatment Strategies in Bicuspid Aortic Valve and Associated Aortopathies

Abstract

Bicuspid aortic valve (BAV) is the most frequent congenital cardiac abnormality leading to premature aortic valve apparatus dysfunction and is often associated with aortopathy. Therefore, current guidelines recommend a surgical aortic valve replacement (SAVR), even if many patients are deemed inoperable owing to their comorbidities and require alternatives such as transcatheter aortic valve replacement (TAVR). However, BAV variations remain challenging for procedural success. Therefore, the latest development in different imaging modalities (echocardiography, multislice-computertomographie, cardiovascular magnetic resonance) allows in-depth analysis for preprocedural risk stratification, follow up, and patient selection. Furthermore, we shed light on the latest developments in pre- and periprocedural fusion imaging as well as on current and future treatment options.

Navigating the challenges of bicuspid aortic valve-aortopathy

“…The diagnostic approach for the initial assessment of BAV involves a transthoracic echocardiography (TTE), which is not only useful in evaluating the valvulopathy but is useful in the assessment of the thoracic aorta 39 . Four commonly used diagnostic imaging 1) 40 . TTE is the imaging technique of choice for identifying BAV, valve morphotype, and for evaluating the severity of valvular dysfunction and guiding appropriate management decisions.…”