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Variable phenotypes of bicuspid aortic valve disease: classification by cardiovascular magnetic resonance
  1. Stefan Buchner1,
  2. Marion Hülsmann1,
  3. Florian Poschenrieder2,
  4. Okka W Hamer2,
  5. Claudia Fellner2,
  6. Reinhard Kobuch3,
  7. Stefan Feuerbach2,
  8. Günter AJ Riegger1,
  9. Behrus Djavidani2,
  10. Andreas Luchner1,
  11. Kurt Debl1
  1. 1Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Germany
  2. 2Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Germany
  3. 3Klink und Poliklinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Universitätsklinikum Regensburg, Germany
  1. Correspondence to Dr Stefan Buchner, Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany; stefan.buchner{at}


Background Recently, cardiovascular magnetic resonance (CMR) has been shown to allow accurate visualisation and quantification of aortic valve disease. Although bicuspid aortic valve (BAV) disease is relatively rare in the general population, the frequency is high in patients requiring valve surgery. The aim of the current study was to characterise the different phenotypes of BAV disease by CMR.

Methods CMR studies were performed on a 1.5 T scanner in 105 patients with BAV.

Results The pattern of BAV phenotypes was as follows: a raphe was identified in 90 patients (86%). Among patients with raphe, 76 patients had fusion between the right and left cusps (RL) and 14 patients had fusion between the right and the non-coronary cusps (RN). There were no significant differences in the aortic dimensions in the different BAV phenotypes.

Conclusion CMR allows excellent characterisation of valve phenotype in patients with BAV. The present data demonstrate that a raphe is present in the vast majority of cases and RL fusion is the predominant phenotype of BAV. No significant differences in the aortic dimensions were observed.

  • Bicuspid aortic valve
  • magnetic resonance imaging
  • aortic stenosis
  • aortic regurgitation
  • surgery-valve
  • echocardiography (transoesophageal)
  • MRI
  • aortic valve disease

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.