ABSTRACT
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" (i.e., 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.
Subject(s)
Aorta, Thoracic/diagnostic imaging , Aortic Diseases/diagnostic imaging , Aortic Valve/abnormalities , Heart Valve Diseases/diagnostic imaging , Tomography, X-Ray Computed/methods , Aorta, Thoracic/pathology , Aortic Diseases/complications , Aortic Diseases/pathology , Aortic Valve/diagnostic imaging , Bicuspid Aortic Valve Disease , Contrast Media , Female , Heart Valve Diseases/complications , Humans , Iohexol/analogs & derivatives , Male , Middle Aged , Radiographic Image Enhancement/methods , Retrospective StudiesSubject(s)
Collateral Circulation , Coronary Vessel Anomalies/diagnosis , Lung/abnormalities , Lung/blood supply , Pulmonary Artery/abnormalities , Coronary Angiography , Coronary Vessel Anomalies/complications , Echocardiography , Electrocardiography , Humans , Male , Middle Aged , Tachycardia, Supraventricular/etiologyABSTRACT
BACKGROUND: Intra-atrial course of the right coronary artery is a rare anomaly. The recognition of this entity is crucial to avoid potential hazards related to vessel injury during interventional procedures such as right heart catheterization, pacemaker implantation, invasive electrophysiology testing or atrial flutter ablation. CASE REPORT: We present a case of a 62-year old female with paroxysmal atrial flutter and atrial fibrillation, whose cardiac computed tomography revealed an anomalous course of the right coronary artery through the right atrium. CONCLUSIONS: Cardiac computed tomography examination enables an accurate assessment of morphology and location of the anomalous vessel course.
