4D flow cardiovascular magnetic resonance for monitoring of aortic valve repair in bicuspid aortic valve disease

Journal of Cardiovascular Magnetic Resonance

Hendrik Kooijman¹  Yskert von Kodolitsch²  Hermann Reichenspurner³  Evaldas Girdauskas³  Johannes Petersen³  Gerhard Adam⁴  Alexander Lenz⁴  Peter Bannas⁴  Julius M. Weinrich⁴  Christoph Riedel⁴  Bjoern P. Schoennagel⁴ 

[1] Clinical Science Department, Philips GmbH;Department of Cardiology, University Heart Center;Department of Cardiovascular Surgery, University Heart Center;Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf;

关键词: 4D flow MRI;    Congenital heart disease;    Bicuspid aortopathy;    Adult congenital heart disease;    Aortic valve repair;    Aorta;   

DOI  :  10.1186/s12968-020-00608-0

来源: DOAJ

【 摘 要 】

Abstract Background Aortic valve repair has become a treatment option for adults with symptomatic bicuspid (BAV) or unicuspid (UAV) aortic valve insufficiency. Our aim was to demonstrate the feasibility of 4D flow cardiovascular magnetic resonance (CMR) to assess the impact of aortic valve repair on changes in blood flow dynamics in patients with symptomatic BAV or UAV. Methods Twenty patients with adult congenital heart disease (median 35 years, range 18–64; 16 male) and symptomatic aortic valve regurgitation (15 BAV, 5 UAV) were prospectively studied. All patients underwent 4D flow CMR before and after aortic valve repair. Aortic valve regurgitant fraction and systolic peak velocity were estimated. The degree of helical and vortical flow was evaluated according to a 3-point scale. Relative flow displacement and wall shear stress (WSS) were quantified at predefined levels in the thoracic aorta. Results All patients underwent successful aortic valve repair with a significant reduction of aortic valve regurgitation (16.7 ± 9.8% to 6.4 ± 4.4%, p < 0.001) and systolic peak velocity (2.3 ± 0.9 to 1.9 ± 0.4 m/s, p = 0.014). Both helical flow (1.6 ± 0.6 vs. 0.9 ± 0.5, p < 0.001) and vortical flow (1.2 ± 0.8 vs. 0.5 ± 0.6, p = 0.002) as well as both flow displacement (0.3 ± 0.1 vs. 0.25 ± 0.1, p = 0.031) and WSS (0.8 ± 0.2 N/m2 vs. 0.5 ± 0.2 N/m2, p < 0.001) in the ascending aorta were significantly reduced after aortic valve repair. Conclusions 4D flow CMR allows assessment of the impact of aortic valve repair on changes in blood flow dynamics in patients with bicuspid aortic valve disease.

【 授权许可】

Unknown