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Aortic Pathology in Patients With Bicuspid Aortic Valve Assessed With Computed Tomography Angiography

Michałowska, Ilona M. MD, PhD*; Kruk, Mariusz MD, PhD; Kwiatek, Paweł MD*; Hryniewiecki, Tomasz MD, PhD; Kowalski, Mirosław MD, PhD§; Furmanek, Mariusz I. MD; Oleksiuk, Tomasz MD*; Waniewska, Joanna MD*; Hoffman, Piotr MD, PhD§

doi: 10.1097/RTI.0000000000000055
Original Articles

Purpose: The aim of the study was to assess thoracic aorta pathologies coexisting with bicuspid aortic valve (BAV) using dual-source computed tomography.

Materials and Methods: A total of 102 patients with BAV diagnosed by electrocardiogram-gated computed tomography angiography of the thoracic aorta were analyzed retrospectively. The morphology of BAV was characterized on the basis of the presence and orientation of cusps and raphes as “pure BAV” (ie, without raphe) or “BAV with raphe.” The assessment included aortic diameters and pathologies such as dilatation, aneurysm, dissection, or coarctation (CoA).

Results: Of the 102 patients, 75 (73.5%) had BAV with raphe, and 27 patients (26.5%) had pure BAV. The analysis revealed significant differences in the diameter of the annulus, the sinuses of Valsalva, the tubular portion of the ascending aorta, and the part of the aorta proximal to the innominate artery between patients with pure BAV and BAV with raphe (respectively 27.18±4.33 vs. 29.88±4.18 mm, P=0.005; 38.11±7.2 vs. 41.77±6.9 mm, P=0.022; 39.07±8.3 vs. 46.31±7.8 mm, P=0.0001; 30.85±6.7 vs. 34.89±5.08 mm, P=0.02). There was a significant difference in prevalence of dilatation and aneurysm of the thoracic aorta between patients with pure BAV and BAV with raphe [58.06% vs. 84.5% (18/31 vs. 60/71), P=0.004]. The prevalence of aortic CoA was higher in patients with pure BAV than in patients with BAV with raphe [44.4% vs. 13.3% (12/27 vs. 10/75), P=0.001].

Conclusions: BAV with raphe is more common than pure BAV and is more often associated with dilatation and aneurysm of the ascending aorta. Pure BAV is more commonly associated with CoA.

Departments of *Radiology

Coronary and Structural Heart Diseases

Heart Valve Diseases

§Congenital Heart Disease in Adults, Institute of Cardiology

Department of Radiology, Centre for Postgraduate Medical Education, Warsaw, Poland

The authors declare no conflicts of interest.

Reprints: Ilona M. Michałowska, MD, PhD, Department of Radiology, Institute of Cardiology, Alpejska 42, 04-628 Warszawa, Poland (e-mail:

© 2014 by Lippincott Williams & Wilkins