Echocardiographic anatomy of ascending aorta dilatation: Correlations with aortic valve morphology and function

Corte, Alessandro Della; Romano, Gianpaolo; Tizzano, Francesco; Amarelli, Cristiano; Santo, Luca Salvatore De; Feo, Marisa De; Scardone, Michelangelo; Dialetto, Giovanni; Covino, Franco Enrico; Cotrufo, Maurizio

doi:10.1016/j.ijcard.2005.11.043

Cited by 41 publications

(29 citation statements)

References 26 publications

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“…However, in our BAV patients with aortic dilatation [ 45 mm, tubular portion of the AA was the most frequently involved location. This finding is consistent with the results of previous studies suggesting a post-stenotic dilatation as a causative mechanism of aortic dilatation in stenotic BAV disease [9,10]. Even though the role of genetically weak aortic wall tissue and hemodynamic turbulence on aortic dilatation in BAV disease is still being debated, aortopathy is currently thought to underlie aortic dilatation in patients with BAV disease.…”

Section: Discussionsupporting

confidence: 92%

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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

Son

Choi

et al. 2011

Int J Cardiovasc Imaging

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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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Section: Discussionsupporting

confidence: 92%

“…CMR is considered the gold standard for the measurement of aortic diameters [7][8][9][10][11][12][13][14][15]. Adequate TTE views of the mid and distal AA and aortic arch, usually the site of maximum dilatation, can be difficult to obtain in patients with BAV [16].…”

Section: Introductionmentioning

confidence: 99%

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

Son

Choi

et al. 2011

Int J Cardiovasc Imaging

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“…Third, while the study would benefit from a larger sample size, the absence of significant differences in the remodeling response of TAV AA and BAV AA concavity tissue is in agreement with the data reported in larger clinical studies that examined the asymmetric nature of aortic dilation and the spatiotemporal patterns of MMP expression in BAV AAs [14][15][16]55,56] . In addition, the same sample size in our previous study was able to demonstrate statistically significant biological differences between convexity specimens subjected to TAV AA and BAV AA WSS.…”

Section: Peer-reviewsupporting

confidence: 82%

Bicuspid aortic valve hemodynamics does not promote remodeling in porcine aortic wall concavity

Atkins

Moore

Sucosky

2016

WJC

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“…This can be used to identify possible stagnation points in the flow, which are related to lipid deposition or calcification. Shearstress patterns on the ascending aorta can be identified that might be linked to dilation of the walls [53,54]. Possibly, even qualitative variations in material parameters based on the amount of calcification could be included using the reflectivity in the echocardiograms [55].…”

Section: Discussionmentioning

confidence: 99%

Towards computational modelling of aortic stenosis

Loon

2009

Numer Methods Biomed Eng

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SUMMARYIn this paper fluid-structure interaction models of bioprosthetic or native aortic valves are proposed for the assessment of aortic stenosis severity. The fictitious domain approach is applied for the blood-valve interaction and the valve and root geometry are defined such that geometrical changes can easily be made. Clinically relevant scenarios are demonstrated using the models by introducing variable stroke volumes, differently shaped valve and root, leaflet fusion or calcifications. Systolic behaviour of the valves is observed and the severity of the occlusions is evaluated using the following clinically relevant criteria: geometrical orifice area, trans-valvular pressure gradient, effective orifice area and Energy loss coefficient. Within this context, the benefits, shortcomings and potential of the presented three-dimensional models are identified and discussed.

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Echocardiographic anatomy of ascending aorta dilatation: Correlations with aortic valve morphology and function

Cited by 41 publications

References 26 publications

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

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

Bicuspid aortic valve hemodynamics does not promote remodeling in porcine aortic wall concavity

Towards computational modelling of aortic stenosis

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