Unicuspid aortic valve disease: a magnetic resonance imaging study

Area of Science:

• Cardiovascular Imaging
• Cardiac Surgery
• Medical Diagnostics

Background:

• Congenital aortic valve malformations are common in adults with aortic valve disease.
• Bicuspid aortic valve disease is the most frequent congenital malformation.
• Unicuspid aortic valve disease (UAV) is a rare congenital anomaly.

Purpose of the Study:

• To describe aortic valve morphology in patients with UAV.
• To measure proximal aortic dimensions in UAV patients.
• To compare UAV morphology and aortic dimensions with tricuspid aortic valve disease (TAV) using MRI.

Main Methods:

• Retrospective analysis of 288 patients with aortic valve disease undergoing 1.5 T MRI.
• 12 patients were classified as having UAV.
• Comparison of aortic annulus and thoracic aorta dimensions between UAV and TAV cohorts.

Main Results:

• All UAV cases exhibited unicuspid unicommissural morphology with a posterior commissure.
• Significantly greater mean annulus areas and ascending aorta diameters were observed in UAV compared to TAV.
• No significant difference in aortic arch diameters; descending aorta diameters were smaller in UAV.

Conclusions:

• MRI provides good image quality for visualizing UAV morphology.
• Dilatation of the proximal aorta (greater than 4.5 cm) is a frequent finding in UAV.
• Additional assessment of aortic dimensions is recommended for patients diagnosed with UAV.