438fac6b368c18f3e2265a883a71fa07 pmc_35054153.pdf 2b9ff14f5fa5fd539221c8a996fc0235b15f2ab4 pmc_35054153.pdf 65e3cccd2fbbdfceee7293cc95cb8a10f1c5276b1b8140bd1d88c6126b12c423 pmc_35054153.pdf Title: Unraveling Bicuspid Aortic Valve Enigmas by Multimodality Imaging: Clinical Implications Subject: Multimodality imaging is the basis of the diagnosis, follow-up, and surgical management of bicuspid aortic valve (BAV) patients. Transthoracic echocardiography (TTE) is used in our clinical routine practice as a first line imaging for BAV diagnosis, valvular phenotyping and function, measurement of thoracic aorta, exclusion of other aortic malformations, and for the assessment of complications such are infective endocarditis and aortic. Nevertheless, TTE is less useful if we want to assess accurately other aortic segments such as mid-distal ascending aorta, where computed tomography (CT) and magnetic resonance (CMR) could improve the precision of aorta size measurement by multiplanar reconstructions. A major advantage of CT is its superior spatial resolution, which affords a better definition of valve morphology and calcification, accuracy, and reproducibility of ascending aorta size, and allows for coronary artery assessment. Moreover, CMR offers the opportunity of being able to evaluate aortic functional properties and blood flow patterns. In this setting, new developed sequences such as 4D-flow may provide new parameters to predict events during follow up. The integration of all multimodality information facilitates a comprehensive evaluation of morphologic and dynamic features, stratification of the risk, and therapy guidance of this cohort of patients. Keywords: bicuspid aortic valve; echocardiography; computed tomography; magnetic resonance imaging; aortic aneurysm Author: Arturo Evangelista Masip, Laura Galian-Gay, Andrea Guala, Angela Lopez-Sainz, Gisela Teixido-Turà, Aroa Ruiz Muñoz, Filipa Valente, Laura Gutierrez, Ruben Fernandez-Galera, Guillem Casas, Alejandro Panaro, Alba Marigliano, Marina Huguet, Teresa González-Alujas and Jose Rodriguez-Palomares Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Jan 17 11:25:42 2022 CET ModDate: Mon Jan 17 12:22:59 2022 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 16 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3213445 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- XPZZYQ+URWPalladioL-Bold Type 1 Custom yes yes no 10 0 XUUVTW+URWPalladioL-Roma Type 1 Custom yes yes no 15 0 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DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4923ab24 Item: Title: Diagnosis and BAV Phenotype Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Familial Screening Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Valvular Dysfunction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Children: Item: Title: Valve Calcification Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Aortic Stenosis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Aortic Regurgitation Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Aorta Involvement Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Imaging Predictors Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Children: Item: Title: Aorta Biomechanics Predictor Parameters Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Aortic Flow Hemodynamic Parameters Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Imaging Surveillance Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Complications: Surgical and TAVI Indications Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Children: Item: Title: Infective Endocarditis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Aortic Dissection Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Aortic Stenosis: Surgical and TAVR Indications Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: Aortic Regurgitation: Valve Repair and Replacement Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: Ascending Aorta Surgery Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Item: Title: Critical Knowledge Gaps Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@76a3e297 Item: Title: Highlights Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4d3167f4 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@ed9d034 Info: Title: Unraveling Bicuspid Aortic Valve Enigmas by Multimodality Imaging: Clinical Implications Author: Arturo Evangelista Masip, Laura Galian-Gay, Andrea Guala, Angela Lopez-Sainz, Gisela Teixido-Turà, Aroa Ruiz Muñoz, Filipa Valente, Laura Gutierrez, Ruben Fernandez-Galera, Guillem Casas, Alejandro Panaro, Alba Marigliano, Marina Huguet, Teresa González-Alujas and Jose Rodriguez-Palomares Subject: Multimodality imaging is the basis of the diagnosis, follow-up, and surgical management of bicuspid aortic valve (BAV) patients. Transthoracic echocardiography (TTE) is used in our clinical routine practice as a first line imaging for BAV diagnosis, valvular phenotyping and function, measurement of thoracic aorta, exclusion of other aortic malformations, and for the assessment of complications such are infective endocarditis and aortic. Nevertheless, TTE is less useful if we want to assess accurately other aortic segments such as mid-distal ascending aorta, where computed tomography (CT) and magnetic resonance (CMR) could improve the precision of aorta size measurement by multiplanar reconstructions. A major advantage of CT is its superior spatial resolution, which affords a better definition of valve morphology and calcification, accuracy, and reproducibility of ascending aorta size, and allows for coronary artery assessment. Moreover, CMR offers the opportunity of being able to evaluate aortic functional properties and blood flow patterns. In this setting, new developed sequences such as 4D-flow may provide new parameters to predict events during follow up. The integration of all multimodality information facilitates a comprehensive evaluation of morphologic and dynamic features, stratification of the risk, and therapy guidance of this cohort of patients. 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2b9ff14f5fa5fd539221c8a996fc0235b15f2ab4 Type: SHA-1