Thoracic aorta evaluation in children with a bicuspid aortic valve: Contribution of magnetic resonance angiography.

Aim: Bicuspid aortic valve (BAV) is the most common congenital valve anomaly causing early valve damage and aortic enlargement. In this study, the contribution of magnetic resonanceangiography (MRA) used for aorta imaging in addition to echocardiography (EC) in pediatric patients with BAV was investigated.
Methods: In a single center study, the medical records of 571 cases with a diagnosis of BAV under 18 years of age were retrospectively reviewed. In this group, 32 patients (21 female, mean age was 12.66 ± 3.92 years) who underwent MRA for aortic evaluation were included in the study. In MRA obtained by phase contrast method, the largest diameters of the annulus, ascending aorta, sinus valsalva, sinotubular junction, middle ascending arch, middle arch and proximal arch levels were measured electronically. Body surface area and arterial blood pressure values obtained and recorded during EC examination were obtained. Z scores were calculated. Ejection fraction, aortic stenosis (AS) and insufficiency (AI) founded with EC were recorded. Aortic arch geometry and supraaortic variations were determined with MRA. The EC and MRA findings, additional findings provided by MRA were evaluated.
Results: In EC, 62.5% of the participants had AI and 6.25% had combined valve disorder. There was no isolated AS, 31.25% of the participants had no valve pathology. The most important diameter change in valve dysfunction was detected at the level of the middle arch. The most common aortic arch was Romanesque (53%).
In the MRA, 15.5% of the participants had bovine arch variation and 3% had isolated left vertebral artery. No correlation was found between valvular disorder, z scores measured by MRA, arterial blood pressure, BSA, aortic geometry, supraaortic variations.
Conclusion: In addition to EC findings in children with BAV, MRA is useful for demonstrating aortic arch geometry and supraaortic variations known to affect hemodynamic changes.
Key words: Bicuspid aort valve, Aorta, Children, Echocardiography, MRI