Differential flow improvements after valve replacements in bicuspid aortic valve disease: a cardiovascular magnetic resonance assessment

Table 3 Ascending aortic flow pattern parameters by aortic valve replacement subgroup

	Healthy Subjects n = 30	BAV- native n = 30	AVR-mechanical n = 11	AVR-tissue n = 10	Ross n = 9	ANOVA
Age in years	43 ± 17	42 ± 16	42 ± 12	58 ± 11	24 ± 12	p < 0.001
Systolic flow angle (°)	7.5 ± 5.3	25.6 ± 13.3*	16.5 ± 9.6	16.2 ± 8.5	9.8 ± 4.9†	p < 0.001
Normalised flow displacement	0.038 ± 0.036	0.133 ± 0.072*	0.083 ± 0.076	0.163 ± 0.064*	0.096 ± 0.067	p < 0.001
Absolute rotational flow (mm²/ms)	3.8 ± 3.1	26.6 ± 16.6*	7.2 ± 3.9†	20.7 ± 8.8*	10.6 ± 10.5†	p < 0.001
Mean systolic WSS_circavg (N/m²)	0.58 ± 0.15	0.77 ± 0.23*	0.67 ± 0.20	0.68 ± 0.20	0.80 ± 0.35	p = 0.012
Absolute systolic in-plane (rotational) WSS (N/m²)	0.07 ± 0.06	0.40 ± 0.28*	0.19 ± 0.13†	0.38 ± 0.19*	0.21 ± 0.17	p < 0.001
Max systolic through-plane WSS (N/m²)	0.76 ± 0.21	0.95 ± 0.44	0.91 ± 0.38	0.78 ± 0.215	1.03 ± 0.65	p = 0.206
RA-LP systolic WSS_circavg (N/m²)	−0.12 ± 0.13	0.22 ± 0.31*	0.27 ± 0.22*	0.36 ± 0.26*	0.24 ± 0.67	p < 0.001
Peak velocity (m/s)	–	2.3 ± 0.8	2.1 ± 0.5	2.1 ± 0.3	1.9 ± 0.8	p = 0.387
Ascending aortic diameter (mm)	28.6 ± 4.3	35.0 ± 6.7*	35.9 ± 4.4*	37.9 ± 5.2*	30.4 ± 8.3	p < 0.001
Diameter at sino-tubuar junction (mm)	27.9 ± 3.6	32.4 ± 6.4*	31.7 ± 7.8	32.9 ± 3.3	31.0 ± 6.0	p = 0.003
Diameter at sinuses (mm)	30.8 ± 3.5	32.9 ± 5.8	34.1 ± 6.7 (pre-AVR)	32.1 ± 2.3 (pre-AVR)	35.9 ± 5.7	p = 0.068
Aortic regurgitant fraction (%)	–	8.8 ± 9.9	3.7 ± 2.8	5.8 ± 7.5	22.8 ± 20.6†	p = 0.002
Left ventricular ejection fraction (%)	–	68 ± 6	67 ± 15	70 ± 8	65 ± 10	p = 0.687

Values are mean ± standard deviation except where indicated; * = p < 0.05 compared to healthy volunteers; † = p < 0.05 compared to native BAV; BAV = bicuspid aortic valve; AVR = aortic valve replacement; WSS = wall shear stress; WSS_circavg = circumferentially averaged wall shear stress; RA-LP = right anterior – left posterior

ISSN: 1532-429X