Background
Classification of phenotypes of bicuspid aortic valves (BAV) has clinical significance in predicting the progression to valve dysfunction or aorta dilatation, as well as choosing the treatment strategies especially in the era of transcatheter aortic valve replacement (AVR). We sought to evaluate the cardiac computed tomography (CT) compared with transthoracic echocardiography (TTE), transesophageal echocardiography (TEE) and surgical findings.
Method(s)
Among patients underwent surgical AVR and preoperative cardiac CT from Jan 2010 to May 2019, 183 patients (119 men, mean age 61±11 years) were suspected of or diagnosed with BAV in TTE. BAV phenotype was classified into 4 types. Diagnostic performances of TTE, TEE and cardiac CT for phenotype discrimination were determined by comparison with surgical findings as the standard reference. Patients were classified into 2 subgroups according to the presence of severe aortic stenosis (AS): Group 1 (severe AS, n=127), Group 2 (non-severe AS, n=56).
Result(s)
Cardiac CT and TEE were well correlated with the surgical findings (κ=0.715, p<0.01; k=0.579, p<0.01, respectively), but TTE findings showed more discrepancy with the surgical findings (κ=0.420, p<0.01). Especially in group 1, the diagnostic performance of cardiac CT (κ=0.754, p<0.01) seems to be more accurate than that of TTE (k=0.364, p<0.01).
Conclusion(s)
Cardiac CT showed a good performance in classifying BAV phenotype especially in patients with severe AS. We suggest that it is useful to apply cardiac CT when the BAV phenotype in TTE is unclear although no intended for the evaluation of concomitant aortic or coronary artery disease.

Phenotype discrimination of bicuspid aortic valve using cardiac computed tomography: comparison with echocardiography and surgical findings

ECHO ASIA is organized by Asian-Pacific Association of Echocardiography (AAE). The meeting combines the basic echocardiography training curriculum and the state-of-the-art lectures/scientific sessions provided by international as well as Asian-Pacific experts. The meeting is a unique forum where scientists from many countries in the Asian-Pacific region who are involved in the field of Doppler echocardiography gather together to exchange knowledge and skills. Various internationally distinguished faculties consent to present their findings and reveal their clinical experiences in ECHO ASIA.