Meeting Banner
Abstract #4448

Hemodynamic Outcome in Patients After Bicuspid and Tricuspid Valve Sparing Aortic Root Repair: A 4D Flow MRI Study

Edouard Michel Semaan1, Michael Markl1, Bradley D. Allen1, Alex Baker1, Chris Malaisrie2, Patrick McCarthy3, James C. Carr4, Jeremy D. Collins4

1Radiology Department, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States; 2Surgery Department, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States; 3Surgery-Cardiac Surgery Department, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States; 4Radiology Department, Northwestern University, Chicago, IL, United States

This study evaluates the impact of aortic root repair on aortic hemodynamic flow in subjects with bicuspid and tricuspid aortic valve morphology without stenosis or significant insufficiency using 4D flow MRI. Aortic root repair results in a more homogeneous flow profile, reduced helical flow patterns, and resolution of forward flow jets impacting the aortic wall compared to control subjects matched with pre-surgical thoracic aortic aneurysm size, age, and aortic valve morphology. These changes occur at the expense of increased peak systolic velocities and regurgitation; the long-term impact of these changes on vascular physiology is unknown.

Keywords

abnormalities absence academic acceleration altered although aneurysm aneurysms anterior aorta aortic arch bicuspid blood cardiac cardiovascular characteristics characterize clearly cohesive cohorts compliance consistently constitute control covering depended depict descending descriptive diameter dilatation directed dissection divided eccentric eccentricity entire evaluated evolution exceeding excellence flow foundation frequent fully generally gold gradients grading graft grants heart helical helix identify identifying illustrated impingement implanted incidence include included independent individual influence initiative intervention jets laminar long loss matched measured medicine memorial morphologies morphology native northwestern note outcome patient patients patterns peak person physiological poorly post posterior preserve procedural profile profiles program proximal quadrant quadrants quantification quantified quantify recent reduce reduced repair resolution resolved respiration restore restored revealed risk root rows rupture scanners school segmental segments significantly sparing speculate strongly studies subjects substantially support surgery surgical systematic systolic table temporal thoracic throughout towards treatment type understood underwent uniformity valve valves velocities velocity visualization visualize visually wall years