Benjamin R. Plaisance, MD, MPH, Michael A. Winkler, MD, Anil K

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Congenital Bicuspid Aortic Valve First Presenting as an Aortic Aneurysm Benjamin R. Plaisance, MD, MPH, Michael A. Winkler, MD, Anil K. Attili, MD, Vincent L. Sorrell, MD The American Journal of Medicine Volume 125, Issue 4, Pages e5-e7 (April 2012) DOI: 10.1016/j.amjmed.2011.11.011 Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 1 Volume-rendered 3-dimensional cardiac computed tomography image, anteroposterior orientation, highlighting the contrast-filled aorta and demonstrating the dilated ascending aorta (arrow). The American Journal of Medicine 2012 125, e5-e7DOI: (10.1016/j.amjmed.2011.11.011) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 2 Volume-rendered 3-dimensional cardiac computed tomography image, blood-pool inversion cross-sectional view of the aortic valve tissue from the perspective of the aorta. The bicuspid aortic valve is seen as 2 leaflets and 2 sinuses of Valsalva. Note the coronaries arise from the same leaflet (right coronary artery seen in cross-section; arrow). The American Journal of Medicine 2012 125, e5-e7DOI: (10.1016/j.amjmed.2011.11.011) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 3 Cardiovascular magnetic resonance 4-dimensional flow image of the aorta in 3 patients with bicuspid aortic valves and normal aortic dimensions. Left: Normal flow pattern. Middle: Abnormal flow pattern shown in patients with a right/non-cusp fusion (these were mostly children with associated valve disease). Right: Visually different abnormal flow patterns consistently seen in patients with right/left cusp fusion. Modified from Hope MD, Hope TA, Meadows AK, et al. Bicuspid aortic valve. Four-dimensional MR evaluation of ascending aortic systolic flow patterns. Radiology. 2010:255:53-61. The American Journal of Medicine 2012 125, e5-e7DOI: (10.1016/j.amjmed.2011.11.011) Copyright © 2012 Elsevier Inc. Terms and Conditions