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KMID : 0880420160170040463
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Korean Journal of Radiology
2016 Volume.17 No. 4 p.463 ~ p.471
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Morphological and Functional Evaluation of Quadricuspid Aortic Valves Using Cardiac Computed Tomography
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Song In-Young
Park Jung-Ah
Choi Bo-Hwa
Ko Sung-Min
Shin Je-Kyoun
Chee Hyun-Keun
Kim Jun-Seok
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Abstract
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Objective: The aim of this study was to identify the morphological and functional characteristics of quadricuspid aortic valves (QAV) on cardiac computed tomography (CCT).
Materials and Methods: We retrospectively enrolled 11 patients with QAV. All patients underwent CCT and transthoracic echocardiography (TTE), and 7 patients underwent cardiovascular magnetic resonance (CMR). The presence and classification of QAV assessed by CCT was compared with that of TTE and intraoperative findings. The regurgitant orifice area (ROA) measured by CCT was compared with severity of aortic regurgitation (AR) by TTE and the regurgitant fraction (RF) by CMR.
Results: All of the patients had AR; 9 had pure AR, 1 had combined aortic stenosis and regurgitation, and 1 had combined subaortic stenosis and regurgitation. Two patients had a subaortic fibrotic membrane and 1 of them showed a subaortic stenosis. One QAV was misdiagnosed as tricuspid aortic valve on TTE. In accordance with the Hurwitz and Robert's classification, consensus was reached on the QAV classification between the CCT and TTE findings in 7 of 10 patients. The patients were classified as type A (n = 1), type B (n = 3), type C (n = 1), type D (n = 4), and type F (n = 2) on CCT. A very high correlation existed between ROA by CCT and RF by CMR (r = 0.99) but a good correlation existed between ROA by CCT and regurgitant severity by TTE (r = 0.62).
Conclusion: Cardiac computed tomography provides comprehensive anatomical and functional information about the QAV.
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KEYWORD
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Aortic valve, Valvular heart disease, congenital, Multidetector computed tomography, Echocardiography, Aortic regurgitation, Magnetic resonance imaging
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