Case: Detection of morphology of aortic valve by cardiac MDCT

History 49-year old male referred to CT for evaluation of aortic valve. Besides asthma and history of colonoscopy, the patient was in good health. Physical examination revealed a heart murmur. The baseline echocardiogram reported normal tricuspid aortic root with moderate aortic regurgitation (AI) and EF of 60 %. Question Detection of morphology of aortic root, and severity of aortic regurgitation for surgical planning. Diagnosis/Differential diagnosis Aortic valve disorder – moderately severe AI Findings The 3D and 4D assessment of aortic root demonstrates a bicuspid aortic valve with partial fusion between non- and right coronary cusps. There is a mild prolapse of the partially fused non- and right cusp with incomplete diastolic coaptation. The area of the diastolic opening measures 0.23 cm². The diastolic opening formed by thick raphe is likely associated with severe aortic insufficiency. The absence of aortic valve calcification is noted. Comments Cardiac MDCT proves to be reliable source for detection of morphology of aortic valve. 4D images of phases between 0-90 % enable functional assessment of aortic valve and identification of degree of severity of valvular disorders. Get the Flash Player to see this player. Movie 1: Cross sectional image of aortic valve showing partial fusion of non- and right coronary cusps, and central diastolic opening. Figure 2: Cross sectional image showing the measurement of diastolic opening area in planimetry. Get the Flash Player to see this player. Movie 3: Image showing mild prolapse of aortic valve cusps and diastolic coaptation. Authors: Sandra Halliburton and Paul Schoenhagen