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Measurement of the ascending aorta diameter in patients with severe bicuspid and tricuspid aortic valve stenosis using dual-source computed tomography coronary angiography

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Abstract

We aimed to evaluate the diagnostic performance of dual-source computed tomography coronary angiography (DSCT-CA) in the measurement of the ascending aorta (AA) diameter and compare the AA diameter in patients with severe bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) stenosis. Eighty-eight consecutive patients (50 men, mean age 60.3 ± 13 year) with severe aortic stenosis (AS) underwent DSCT-CA before aortic valve surgery. Seventy-four of the 88 patients underwent cardiovascular magnetic resonance (CMR). The internal diameter of AA was measured from early-systole with DSCT-CA and CMR by 2 radiologists independently at 4 levels (aortic annulus, sinuses of Valsalva, sinotubular junction, and tubular portion at the right pulmonary artery). The patients were divided in to 2 groups (BAV [n = 53]; TAV [n = 35]) according to operative findings. Patients with BAV were significantly younger than those with TAV (P = 0.0035). Inter-observer agreement of AA diameters at 4 levels with DSCT-CA and CMR was excellent (intraclass correlation coefficient = 0.89–0.97). Also, the DSCT-CA and CMR measurements of the AA diameter strongly correlated (r = 0.871–0.976). Mean diameter of the AA by DSCT-CA was significantly larger in patients with BAV (34.4 ± 8.2 mm) as compared to those with TAV (30.6 ± 5.5 mm). The diameters at the sinuses of Valsalva, sinotubular junction, and tubular portion were significantly larger in BAV than in TAV. Twenty-two of 53 (41.5%) patients with BAV and 2 of 35 (5.7%) patients with TAV had AA dilatation > 45 mm. DSCT-CA allows accurate assessment of the AA diameters in patients with severe AS. Patients with severe BAV stenosis had larger AA diameters and higher prevalence of AA dilatation > 45 mm as compared to those with severe TAV stenosis.

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Abbreviations

AA:

Ascending aorta

AR:

Aortic regurgitation

AS:

Aortic stenosis

AVA:

Aortic valve area

BAV:

Bicuspid aortic valve

CAD:

Coronary artery disease

CMR:

Cardiovascular magnetic resonance

DLP:

Dose-length product

DSCT-CA:

Dual-source computed tomography coronary angiography

ECG:

Electrocardiography

HR:

Heart rate

LV:

Left ventricular

LVOT:

Left ventricular outflow tract

MDCT:

Multidetector computed tomography

TAV:

Tricuspid aortic valve

TEE:

Transesophageal echocardiography

TTE:

Transthoracic echocardiography

VHD:

Valvular heart disease

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Acknowledgments

The authors would like to thank the CT and MR technologists, the Radiology department nursing staff, the Cardiology department staff physicians, and the residents in the Division of Thoracic Surgery at the Konkuk University Hospital. This paper was supported by Konkuk University in 2009.

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Authors and Affiliations

  1. Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea

    Jee Young Son, Sung Min Ko & Jin Woo Choi

  2. Department of Thoracic Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea

    Meong Gun Song

  3. Department of Cardiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea

    Hweung Kon Hwang

  4. Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea

    Sook Jin Lee

  5. Department of Radiology, Asan Medical Center, Ulsan University School of Medicine, Seoul, Korea

    Joon-Won Kang

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  1. Jee Young Son
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Correspondence to Sung Min Ko.

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Son, J.Y., Ko, S.M., Choi, J.W. et al. Measurement of the ascending aorta diameter in patients with severe bicuspid and tricuspid aortic valve stenosis using dual-source computed tomography coronary angiography. Int J Cardiovasc Imaging 27 (Suppl 1), 61–71 (2011). https://doi.org/10.1007/s10554-011-9956-5

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  • DOI: https://doi.org/10.1007/s10554-011-9956-5

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