John-Paul Jaewoon Yu MD, PhD, Presenter: Nothing to Disclose

Thomas Urbania MD, Abstract Co-Author: Nothing to Disclose

Elaine Tseng MD, Abstract Co-Author: Nothing to Disclose

Michael D. Hope MD, Abstract Co-Author: Nothing to Disclose

To evaluate the role of incidental aortic valve calcification on routine computed tomographic (CT) scans of the thorax as a marker for stenosis, as assessed by echocardiography, in patients with bicuspid and tricuspid aortic valves (BAV and TAV).

Patient informed consent was waived by the institutional review board that approved the study. CT and echocardiography studies were retrospectively reviewed for 182 consecutive, unselected patients and 434 patients identified by a record search for “aortic valve calcification.” Location and severity of aortic valve calcification were correlated with aortic valve morphology and stenosis. Differences between subgroups were assessed using a chi-square or Fisher’s exact test.

In unselected patients, calcification was present in 22.5% with TAV (60/194) and 75% (3/4) with BAV. In patients selected for valve calcification, the average age with TAV (n = 403) was 14.2 years older than with BAV (n = 31). Severe calcification corresponded with presence of aortic stenosis in patients with TAV (67% versus 23% of patients with nonsevere calcification), but the same was not true for patients with BAV (86% and 60% of patients with severe and nonsevere calcification respectively had aortic stenosis). Patients under 60 years old were more likely to have BAV (23.9% versus 3.9%; odds ratio = 7.8, CI(95%) 3.7 – 16.8).

Aortic valve calcification was found 14 years earlier in patients with BAV than TAV, and severity of calcification was less predictive of aortic stenosis. Presence of any aortic valve calcification on CT scan should be considered a marker for BAV if found before the 7th decade.

Aortic valve calcifications in patients under 60 years old may indicate valve disease and echocardiography may be warranted to identify BAV before progression to advanced aortic valve disease.

Yu, J, Urbania, T, Tseng, E, Hope, M, Incidental Aortic Valve Calcification on CT Scans: Significance for Bicuspid and Tricuspid Valve Disease.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004519.html