An Athlete With Bicuspid Aortic Valve Regurgitation and Left Ventricular Dilatation

Figures

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  Figure 1. 12-Lead Electrocardiogram A 12-lead electrocardiogram demonstrating sinus bradycardia and voltage criteria for left ventricular hypertrophy.

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  Figure 2. Parasternal Long-Axis Transthoracic Echocardiogram Parasternal long-axis transthoracic echocardiogram showing severe left ventricular dilatation with an end-diastolic diameter of 70 mm. The interventricular septum measured 10 mm.

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  Figure 3. Short-Axis Transthoracic Echocardiogram View Short-axis transthoracic echocardiogram view at the level of the aortic valve. Two cusps are demonstrated with no discernible raphe (type 0 bicuspid aortic valve). The leaflets are freely mobile, and no significant calcification is seen.

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  Figure 4. Transthoracic Echocardiogram Transthoracic echocardiogram demonstrating a posteriorly directed, highly eccentric jet of at least moderate aortic regurgitation in the (left) apical 3-chamber and (right) parasternal long-axis view. The quantitative assessment of aortic regurgitation severity may be underestimated by the transthoracic echocardiogram because of the eccentric nature of the jet and the hyperdynamic left ventricular function. Subsequent cardiac magnetic resonance demonstrated a regurgitant fraction of 43% and a regurgitant volume of 84 mL.

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  Figure 5. Transthoracic Echocardiogram Transthoracic echocardiogram views of the aorta demonstrating (A) a sinus of Valsalva diameter of 49 mm and (B) an ascending aorta diameter of 42 mm.

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  Figure 6. Magnetic Resonance Aortogram Magnetic resonance aortogram demonstrating severe dilatation of the aortic root and no associated coarctation.

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  Figure 7. Parasternal Long-Axis Transthoracic Echocardiogram Postoperative parasternal long-axis transthoracic echocardiogram (TTE) showing a left ventricular end-diastolic diameter of 57 mm. The metallic aortic valve can be seen with the root replacement. The “+” just denotes the start and finish of the measurement lines.