A simple method to visualize the bicuspid aortic valve pathology by cardiac computed tomography

Area of Science:

• Cardiovascular Imaging
• Cardiac Surgery
• Medical Diagnostics

Background:

• Bicuspid aortic valve (BAV) disease encompasses a range of anomalies with various classification systems based on imaging and pathology.
• Existing BAV classifications often rely on echocardiography, surgical findings, or pathology, with recent advancements in cardiac CT.
• Accurate BAV characterization is crucial for guiding treatment, particularly for patients undergoing transcatheter aortic valve replacement (TAVR).

Purpose of the Study:

• To present a novel, simple cardiac CT technique for visualizing the aortic valve leaflets' insertion lines and interleaflet triangles.
• To enable a pathology-like visualization of BAV anatomy using three-dimensional curved multiplanar reconstruction.
• To facilitate a detailed categorization of BAV anatomy based on interleaflet triangle development.

Main Methods:

• Utilized three-dimensional curved multiplanar reconstruction imaging from cardiac CT.
• Developed a technique to visualize the full line of insertion (Hinge) of aortic valve leaflets.
• Focused on visualizing interleaflet triangles to assess the degree of underdevelopment or absence.

Main Results:

• The described method provides a clear, pathology-like visualization of the aortic valve's hinge lines and interleaflet triangles.
• This technique allows for detailed anatomical categorization of specific BAV presentations.
• The visualization aids in assessing the degree of underdevelopment or absence of interleaflet triangles.

Conclusions:

• This cardiac CT technique offers a valuable tool for detailed BAV anatomy assessment.
• Improved imaging-based analysis of BAV patients undergoing TAVR is anticipated.
• The findings may lead to a standardized BAV classification based on effective pathological appearance for TAVR candidates.