Abstract 14162: Assessment of Aortic Morphology in Patients with Bicuspid Aortic Valve: Echo vs CMR
Background: Bicuspid aortic valve (BAV) is a common congenital cardiac abnormality, often involving aneurysmal dilatation of the aorta. Recent guidelines recommend screening of aortic size and periodic surveillance by non-invasive imaging. We compared aortic measurement by transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) in a cohort of patients with BAV undergoing aortic valve surgery (AVS).
Methods: We evaluated 62 adult patients with BAV (85% male), mean age 54 ± 13 (SD) years, who underwent both TTE and CMR imaging prior to AVS between April 2004 to November 2007. Internal dimensions of the aorta were measured at the sinuses of Valsalva (SV), the sinotubular junction (STJ) and the proximal ascending aorta (PAA). CMR measurements were performed from 3D MRA images. On TTE, the PAA was measured at largest dimension of the visualized segment (range 2–5 cm above the STJ). More than half the patients had measurable dimensions on TTE. Data analysis was performed using paired t-test for mean of difference and Pearson Correlation coefficient(r). Agreement was defined as measurements within 1 mm.
Results: Aortic root measurements at the SV and STJ were similar with TTE and CMR. TTE measurements of the PAA were larger than with CMR, with greater correlation in patients with aortic root or PAA dilatation (Table).
Conclusions: PAA cannot be reliably measured by TTE as compared to CMR. Although TTE correlates well with CMR in patients with dilatation of the aortic root and PAA, TTE significantly overmeasures PAA compared to CMR data. The ovoid shape of the aorta in BAV may play a role in this. As the ability of TTE to assess the PAA may be limited by inability to obtain accurate visualization of the entire PAA, TTE and CMR play complimentary roles in the assessment of patients with BAV.
- © 2011 by American Heart Association, Inc.