Measurement of the ascending aorta diameter in patients with severe bicuspid and tricuspid aortic valve stenosis using dual-source computed tomography coronary angiography

Son, Jee Young; Ko, Sung Min; Choi, Jin Woo; Song, Meong Gun; Hwang, Hweung Kon; Lee, Sook Jin; Kang, Joon‐Won

doi:10.1007/s10554-011-9956-5

Cited by 14 publications

(8 citation statements)

References 29 publications

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“…The sensitivity and specificity of angioscans have increased greatly in the last few years reaching up to 100% [20], thus becoming comparable to MRI. Recently, a published study [21] demonstrated that dual source CT scan is as accurate as MRI in documenting TAA diameters in patients with BAV and a stenotic aortic valve which comes to reinforce the role of CT scanning in the diagnosis of TAA dilatation.…”

Section: Diagnosismentioning

confidence: 96%

The ascending aortic aneurysm: When to intervene?

Saliba

Sia

Dore

et al. 2015

IJC Heart & Vasculature

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BackgroundThoracic ascending aorta aneurysms (TAA) are an important cause of mortality in adults but are a relatively less studied subject compared to abdominal aortic aneurysms (AAA). The purpose of this review is to explain the main aspects (etiology, pathophysiology, diagnosis) of this disease and to summarize the most recent developments in its management.MethodologyLiterature was obtained through online health related search engines (PubMed, MEDLINE) by including the following keywords: ascending aorta aneurysm, thoracic aneurysms, Marfan syndrome, bicuspid aortic valve, familial thoracic syndrome, aortic dissection, aorta imaging and aortic aneurysm guidelines. We included articles dating from 1980 to 2014.FindingsLiterature revealed how lethal this disease can be and how simple steps such as follow-up and prophylactic surgery can significantly reduce morbidity and mortality. This review also allowed us to realize the many developments that have been made in recent years in the understanding of pathologic mechanisms of this disease.ConclusionTAA is a silent disease that needs to be recognized early in its course and followed closely in order to recommend appropriate preventive and prophylactic therapy in a timely manner.

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Section: Diagnosismentioning

confidence: 96%

The ascending aortic aneurysm: When to intervene?

Saliba

Sia

Dore

et al. 2015

IJC Heart & Vasculature

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“…Little is known how the modified anatomy of BAV patients affects the definition of the annulus plane [21,22]. As a consequence, the abovementioned technique based on the three hinge points has been previously applied also to datasets of patients with BAV regardless of valve type [13,[28][29][30]. We did not find this method feasible for all BAV patients.…”

Section: Discussionmentioning

confidence: 94%

Bicuspid aortic valve annulus: assessment of geometry and size changes during the cardiac cycle as measured with a standardized method to define the annular plane

et al. 2021

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Purpose Bicuspid aortic valve (BAV) is a complex malformation affecting not merely the aortic valve. However, little is known regarding the dynamic physiology of the aortic annulus in these patients and whether it is similar to tricuspid aortic valves (TAV). Determining the BAV annular plane is more challenging than for TAV. Our aim was to present a standardized methodology to determine BAV annulus and investigate its changes in shape and dimensions during the cardiac cycle. Methods BAV patients were prospectively included and underwent an ECG-gated cardiac CTA. The annulus plane was manually identified on reconstructions at 5% intervals of the cardiac cycle with a new standardized method for different BAV types. Based on semi-automatically defined contours, maximum and minimum diameter, area, area-derived diameter, perimeter, asymmetry ratio (AR), and relative area were calculated. Differences of dynamic annular parameters were assessed also per BAV type. Results Of the 55 patients included (38.4 ± 13.3 years; 58% males), 38 had BAV Sievers type 1, 10 type 0, and 7 type 2. The minimum diameter, perimeter, area, and area-derived diameter were significantly higher in systole than in diastole with a relative change of 13.7%, 4.8%, 13.7%, and 7.2% respectively (all p < 0.001). The AR was ≥ 1.1 in all phases, indicating an elliptic shape, with more pronounced flattening in diastole (p < 0.001). Different BAV types showed comparable dynamic changes. Conclusions BAV annulus undergo significant changes in shape during the cardiac cycle with a wider area in systole and a more elliptic conformation in diastole regardless of valve type. Key Points • A refined method for the identification of the annulus plane on CT scans of patients with bicuspid aortic valves, tailored for the specific anatomy of each valve type, is proposed. • The annulus of patients with bicuspid aortic valves undergoes significant changes during the cardiac cycle with a wider area and more circular shape in systole regardless of valve type. • As compared to previously published data, the bicuspid aortic valve annulus has physiological dynamics similar to that encountered in tricuspid valves but with overall larger dimensions.

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“…Adhesion or fusion at the valve junction may lead to restriction of valve opening and valve orifice stenosis, consequently resulting in a series of morphological changes in the right ventricle and pulmonary artery. In addition, abnormalities in the number of pulmonary artery valve or dysplasia trigger PS ( 21 ). Congenital heart disease is often associated with bicuspid valve malformation, valves and valve annulus dysplasia, as well as fusion at the valve junction ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Dual-Source Computed Tomography Evaluation of Children with Congenital Pulmonary Valve Stenosis

Sun

Huang

et al. 2016

Iran J Radiol

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BackgroundDespite dual-source computed tomography (DSCT) technology has been performed well on adults or infants with heart disease, specific knowledge about children with congenital pulmonary valve stenosis (PS) remained to be established.ObjectivesThis original research aimed to establish a professional approach of DSCT performing technology on children and to assess the image quality performed by DSCT to establish a diagnostic evaluation for children with PS.Patients and MethodsNinety-eight children with congenital PS referred to affiliated hospital of Jining medical college were recruited from October 2013 to March 2015. Participants were divided into four groups according to different ages (0 - 1, 1 - 3, 3 - 7, 7 - 14), or three groups according to different heart rates (< 90, 90 - 110, > 110). Image quality of pulmonary valves was assessed based on a four-point grading scale (1 - 4 points). Those cases achieving a score of ≥ 3 points were selected for further investigation, which played a critical role in our analysis. Correlation analysis was used to identify the effects of age and heart rate on image quality. Additionally, the results evaluated by DSCT were compared with those evaluated from the operation, further confirming the accuracy of DSCT.ResultsSeventy-two cases (73.4%) achieved a score of ≥ 3 points based on pulmonary valve imaging, which were available for further diagnosis. There was a statistically significant difference (P < 0.05) between the four groups except 0 - 1 group and 1 - 3 group, 3 - 7 group and 7 - 14 group, and the image quality of elder group was higher than younger group. Image score was gradually decreased with increased heart rate (F = 19.05, P < 0.01). Heart rate was negatively correlated with pulmonary valve scores (r = -0.391, P < 0.001), while there was no correlation between age and scores (r = 0.185, P = 0.070). The number, shape, commissure, and opening status of pulmonary valves evaluated by DSCT were the same as the results of operation.ConclusionHeart rate serves a pivotal role in imaging quality of DSCT. DSCT provides a functional evaluation of children with congenital PS and consequently contributes to a theoretical basis for corresponding treatment protocols.

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Measurement of the ascending aorta diameter in patients with severe bicuspid and tricuspid aortic valve stenosis using dual-source computed tomography coronary angiography

Cited by 14 publications

References 29 publications

The ascending aortic aneurysm: When to intervene?

The ascending aortic aneurysm: When to intervene?

Bicuspid aortic valve annulus: assessment of geometry and size changes during the cardiac cycle as measured with a standardized method to define the annular plane

Dual-Source Computed Tomography Evaluation of Children with Congenital Pulmonary Valve Stenosis

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