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BACKGROUND: Abnormal aortic flow patterns in bicuspid aortic valve disease (BAV) may be partly responsible for the associated aortic dilation. Aortic valve replacement (AVR) may normalize flow patterns and potentially slow the concomitant aortic dilation. We therefore sought to examine differences in flow patterns post AVR. METHODS: Ninety participants underwent 4D flow cardiovascular magnetic resonance: 30 BAV patients with prior AVR (11 mechanical, 10 bioprosthetic, 9 Ross procedure), 30 BAV patients with a native aortic valve and 30 healthy subjects. RESULTS: The majority of subjects with mechanical AVR or Ross showed normal flow pattern (73% and 67% respectively) with near normal rotational flow values (7.2 ± 3.9 and 10.6 ± 10.5 mm2/ms respectively vs 3.8 ± 3.1 mm2/s for healthy subjects; both p > 0.05); and reduced in-plane wall shear stress (0.19 ± 0.13 N/m2 for mechanical AVR vs. 0.40 ± 0.28 N/m2 for native BAV, p  0.05), and a similar pattern for wall shear stress. Data before and after AVR (n = 16) supported these findings: mechanical AVR showed a significant reduction in rotational flow (30.4 ± 16.3 → 7.3 ± 4.1 mm2/ms; p 

Original publication




Journal article


J Cardiovasc Magn Reson

Publication Date





4D flow, Aortic disease, Aortic valve replacement, Bicuspid aortic valve, Magnetic resonance imaging, Adolescent, Adult, Aged, Aortic Valve, Bicuspid Aortic Valve Disease, Bioprosthesis, Blood Flow Velocity, Case-Control Studies, Child, Cross-Sectional Studies, Female, Heart Valve Diseases, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, Hemodynamics, Humans, Image Interpretation, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Myocardial Perfusion Imaging, Predictive Value of Tests, Prospective Studies, Prosthesis Design, Recovery of Function, Stress, Mechanical, Time Factors, Treatment Outcome, Young Adult