Aortic valve and aortic root features in CT angiography in patients considered for aortic valve repair |
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| Affiliation: | 1. Oslo University Hospital, Rikshospitalet, Center for Cardiological Innovation and University of Oslo, Oslo, Norway;2. McMaster University, Hamilton, Ontario, Canada;3. Methodist DeBakey Heart and Vascular Center, Houston, Texas;4. Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;5. Cleveland Clinic, Cleveland, Ohio;6. Cardiology Division, Yonsei University College of Medicine, Seoul, Korea;1. Department of Cardiology, William Beaumont Hospital, 3601 13 Mile Road, Royal Oak, MI 48073, USA;2. Baptist Hospital of Miami and Baptist Cardiac and Vascular Institute, Miami, FL 33176, USA;3. Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA;4. Lenox Hill Heart & Vascular Institute, New York, NY 10075, USA;5. University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA;6. Department of Emergency Medicine, Wayne State University, School of Medicine, Detroit, MI 48201, USA;7. Georgetown University Hospital, Washington, DC 20007, USA;8. Massachusetts General Hospital, Boston, MA 02114, USA;1. Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan;2. Department of Cardiology, Mie University School of Medicine, Tsu, Japan;1. Department of Radiology and Division of Cardiology, St Paul''s Hospital, 1081 Burrard Street, Vancouver V6Z 1Y6, BC, Canada;2. Fairfax Radiology, Virginia, USA;3. New York Presbyterian/Weil Cornell Medical College, New York, NY, USA;4. Department of Radiology, Buenos Aires University School of Medicine, Buenos Aires, Argentina;1. Department of Cardiology, Aarhus University Hospital, Brendstrupgaardsvej 100, Skejby, 8200 Aarhus N, Denmark;2. Harrington Heart and Vascular Institute, Case Medical Center, Cleveland, OH, USA;3. Department of Cardiology, Golden Jubilee National Hospital, Glasgow, Scotland;4. Department of Radiology, St. Paul''s Hospital, Vancouver, BC, Canada;5. Department of Cardiology, University of Erlangen, Erlangen, Germany;1. Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan;2. Department of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan;3. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan |
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| Abstract: | BackgroundThe underlying mechanism of aortic regurgitation and aortic valve and root characteristics are associated with the durability of surgical repair.ObjectiveWe investigated whether multidetector CT (MDCT) identifies the characteristics of the aortic valve and root that may be associated with the ability to perform successful surgical repair.MethodsSixty-one patients with aortic regurgitation and/or aortic root pathology who were evaluated for aortic valve or root repair and underwent clinically indicated gated or nongated MDCT of the aortic valve and aortic root were included in the present analysis. Patients with endocarditis were excluded. MDCT data of aortic valve anatomy and calcification and thoracic aorta dimensions were analyzed.ResultsThe aortic valve and root was successfully repaired in 36 patients (55 ± 13 years; 61% male; median EuroSCORE II, 3.8%) whereas in 25 patients (56 ± 15 years; 52% male; median EuroSCORE II, 2.5%) repair was not attempted (n = 20) or valve repair was converted to aortic valve replacement during surgery (n = 5). In patients in whom repair was considered not possible or failed, there was a higher percentage of bicuspid aortic valves (48% vs 17%; P = .019), more severe commissural calcification, and more severe annular calcification.ConclusionThe degree of commissural and annular calcification of the aortic valve determined by MDCT is inversely related to the ability to perform surgical valve repair instead of replacement. Similarly, bicuspid valve anatomy predicts failure to perform repair. |
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| Keywords: | Aortic root pathology Aortic regurgitation Computed tomography Aortic valve repair Aortic root replacement |
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