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Bicuspid Aortic Valve (2 Sinus) Case Review

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In this next case, we're gonna review a patient with bicuspid aortic valve.

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So we're starting with the standard N P R views, coronal, axial,

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sagittal.

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And I'm gonna get myself into a short axis plane to get a good look at the

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aortic valve. So as we've described before,

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I like to start with the coronal in this particular software.

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It's up in the upper right hand corner,

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and I go to the coronal and drop a crosshairs for my NPRs

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right at the middle of the valve leaflets.

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And then I rotate my axial plane counterclockwise so that I am

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parallel to the aortic valve.

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I repeat the process for my other long axis image here,

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and then I take a look on the short axis at what we've got.

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In this particular case, you can see it's a heavily calcified aortic valve.

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There's some window, a little wider here. In addition to all the calcification,

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it looks like there're actually two distinct cusps.

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There's this cusp right here, and then there's this cusp right here. Um,

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as you scroll inferiorly, you can see the gap between the two cusp.

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That's the valve opening and it's opening's very restricted in this particular

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patient. Um, and you can see I have one cusp here and one cusp here.

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Now what I'm gonna do is I'm gonna hit the syne button so that we can actually

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page through all the different parts of the cardiac cycle and we can get a look

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at the opening of these cusps throughout the cycle.

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So it's gonna just take a second to load in.

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And you can actually see in this particular patient that this more posterior

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part of the valve is actually open better than the more anterior part of the

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valve. And that, you know,

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makes sense given the degree of calcification that we see anteriorly.

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But you can also appreciate that we really only see two cusps throughout the

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entire cardiac cycle. We don't see that third cusp.

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And this is what we would call a two cusp bicuspid valve

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rather than diffuse subtype, which we're gonna discuss in a separate video.

Report

Faculty

Stefan Loy Zimmerman, MD

Associate Professor of Radiology and Radiological Science

Johns Hopkins Medicine Department of Radiology and Radiological Science

Tags

Vascular

Idiopathic

Congenital

Cardiac valves

Cardiac CT (SCCT Cat B1 Video Case)

Cardiac

CTA

CT

Acquired/Developmental