prevalence and characterization of a bicuspid aortic valve in ct examinations

Background

Trans-catheter aortic valve implantation (TAVI) has become an alternative to surgical aortic valve replacement in high-moderate risk patients. Since there are therapeutic implications on the TAVI procedure, it is of great importance to assess the prevalence of patients with bi-cuspid aortic valve (BAV) among patients referred for TAVI, and furthermore - to characterize the types of BAV in these patients.

Methods

The aim of the current study was to quantify and characterize BAV in computerized tomography (CT) exams and to quantify calcium score (CS) in BAV. An observational study of 337 consecutive patients was conducted in whom CT exams were analyzed according to TAVI-CT protocol from 2014-2018 at the Shaare Zedek Medical Center. Quality assessment, analysis according to Sievers et al`s definitions and clinical characteristics of the patients were performed.

Results

Mean age 79.7 years old, 55% were male. Of them 84% suffered from hypertension, 58% from dyslipidemia, 18% were smokers and 15% suffered from diabetes mellitus. BAV prevalence was 1.5%, with 2 (40%) defined as "Type 0" and 3 (60%) as "Type 1" according to the BAV classification. Mean CS in regular valves vs. BAV was 2231 ± 1436 AU vs. 4614 ± 2666 AU, respectively, p<0.001.

Conclusion

The prevalence of BAV in CT TAVI exams is low, and average CS in BAV patients is higher than in regular valves and has significance for the operator.