Cusp fusion pattern in bicuspid aortic valve disease predicts severity of aortic flow abnormalities

Methods We prospectively enrolled 80 patients (51 with rightleft-coronary-cusp fusion pattern [RL-BAV] and 29 with right-non-coronary-cusp fusion pattern [RN-BAV]), and 27 healthy volunteers (HV) with a mean age across groups of 42±16 years. Time-resolved 3-dimensional flow-sensitive magnetic resonance imaging was used to quantify flow abnormalities and local distribution of WSS in the ascending aorta. The amount of helical blood flow was quantified using the planar fluid circulation measure. ‘Normal’ flow patterns in HV involved a very mild right or left-handed helix (mean planar fluid circulation 3.2± 2SD: -5 to +11 mm/s). Abnormal right-handed helical flow pattern was defined as planar fluid circulation >11 mm/s and abnormal left-handed helical flow pattern as <-5 mm/s. Complex flow was visually defined as disintegration of the helical flow pattern.