Is there a role for cardiovascular magnetic resonance imaging in the assessment of biological aortic valves?

Figures

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  Figure 1. Example of a surgical stented bioprosthetic aortic valve (perimount) visualized in the coronal left ventricular outflow tract (LVOT) (A) and the medtronic corevalve prosthesis visualized in a three-chamber view (B). The ferromagnetic component of the prostheses generated important artefacts, particularly for the corevalve prosthesis.

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  Figure 2. Example of a stentless aortic prosthesis (freestyle) visualized in three-chamber view bSSFP sequences, free from any artefacts and appearing as a native aortic valve.

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  Figure 3. Visualization of the prosthetic orifice of a stentless aortic valve (freestyle) (A) obtained from two orthogonal planes: three-chamber view (B) and coronal LVOT (C). The red line indicates the slice position. Visualization of the leaflets allows easy planimetry.

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  Figure 4. Visualization of the prosthetic orifice of a surgical stented bioprosthetic aortic valve (saint-jude 25) obtained from a three-chamber view (A). The visualization of leaflets for planimetry is more challenging (B).

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  Figure 5. Visualization of the orifice of the Edwards-Sapien prosthesis (A) obtained from two orthogonal planes: three-chamber view (B) and coronal LVOT (C). CMR stent-related artefacts prevent accurate aortic valve planimetry.

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  Figure 6. Example of direct quantification of severe aortic regurgitation for a patient with a degenerated surgical aortic prosthesis (perimount). The perpendicular line (red) above the prosthesis (A) indicates the scanning position for phase-contrast velocity mapping, generating phase (B) and magnitude (C) images and a flow curve image (D). The aortic regurgitant volume is represented by the area under the diastolic flow curve (71 ml); the regurgitant fraction is calculated as the aortic backward volume/aortic forward volume = 71/121.7 = 58.3%.