Bicuspid Aortic Valve

 

Image Library Home >>Congenital Disorders >> Bicuspid Aortic Valve
  • Example 1
  • Example 2

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This parasternal long axis shows a subtle abnormality of the aortic valve. Note the point of coaptation of the aortic valve is not central, but rather more anterior. The value also doesn't appear to open normally. This may also be demonstrated with M mode echocardiography. The ascending aorta also appears dilated. These features together should make one suspicious about a bicuspid aortic valve.
Formal measurements in this view indeed show that the ascending aortic size is abnormally increased, here clearly above 4 cm.

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The parasternal short axis view shows a bicuspid aortic valve, which is easily appreciated when looking with a zoomed in view on the valve. This individual has fusion of the right and left coronary cusps with a raphe present. This individual did not have significant stenosis or regurgitation.

 

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In this intraoperative TEE short axis view, we see a calcified bicuspid valve with fusion between the right and non coronary cusps (different from example 1) with a raphe. Note also the swan ganz catheter, placed at the time of surgery.