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Transthoracic Echocardiographic Visualization of Calcification of the Sinotubular Ridge of the Ascending Aorta
Ivan A. D'Cruz1, Erick Calderon, Regenia Clark
1Cardiology Section, VA Medical Center, 1030 Jefferson Avenue, Memphis, TN 38104.
Insights
Echocardiography reveals calcification of the sinotubular ridge, a finding previously undocumented by imaging. This distinct calcific deposit in the ascending aorta requires differentiation from atheromatous plaques.
Area of Science:
- Cardiovascular Imaging
- Cardiac Anatomy
- Aortic Pathology
Background:
- Calcification of the sinotubular ridge (STR) has been observed during autopsies.
- No prior echocardiographic descriptions of STR calcification exist.
- Understanding imaging characteristics is crucial for accurate diagnosis.
Purpose of the Study:
- To describe the two-dimensional echocardiographic features of sinotubular ridge calcification.
- To differentiate STR calcification from other aortic pathologies.
Main Methods:
- Two-dimensional echocardiography was performed on 33 male patients (mean age 69 years).
- Echocardiographic images were analyzed to identify and characterize STR calcification.
- Associated calcifications in cardiac structures were also noted.
Main Results:
- Sinotubular ridge calcification appeared as a dense echo at the junction of the aortic sinus and tubular ascending aorta.
- Frequent co-occurrence of calcification in aortic valve cusps, mitral annulus, and papillary muscles was observed.
- STR calcification is a distinct entity separate from atheromatous aortic plaques.
Conclusions:
- Two-dimensional echocardiography can visualize sinotubular ridge calcification.
- This finding is associated with other cardiac calcifications.
- Distinguishing STR calcification from atheromatous plaques is essential.
Abstract:
Calcification of the ridge between the sinus of Valsalva and the tubular segments of the ascending aorta has been documented at autopsy, but no echocardiographic description has yet been published. We describe the two-dimensional echocardiographic appearances in 33 men (mean age, 69 years). Sinotubular ridge calcification manifested as a dense small echo projecting into the aortic lumen, precisely at the junction of the sinus of Valsalva and tubular aortic segments. Calcification in the aortic valve cusps, mitral annulus, basal mitral leaflets, and papillary muscles also were frequently present. This previously unknown entity must be distinguished from atheromatous aortic plaques.