Prospective 4D CTA of BAV Competence
Prospective 4D CTA of BAV Competence
The study involves annual 4D CTA imaging of the bicuspid aortic valve for a period of 5
 years. CTA is often standard of care for BAV patients, but patients in this study will
 receive a higher radiation dose with a 4D imaging protocol. There may also be patients
 enrolled in the study who have a 4D CTA for research purposes when a routine CTA is not
 required for clinical care.
The bicuspid aortic valve (BAV) is the most common congenital heart disease. The purpose of
 this study is to better understand the anatomy of physiologically normal, or competent, BAVs
 without stenosis or insufficiency (AI) in order to support evidence-based standardization of
 BAV repair surgery. Men and women over 18 years of age with a diagnosis of BAV and minimal
 aortic valve calcification at baseline will undergo annual 4D computed tomography angiography
 (CTA) scans, routine transthoracic echocardiograms, and history and physical assessments over
 the course of the 5-year study period. Patients who are pregnant, have renal insufficiency
 (creatinine 2 mg/dL), or who have a contraindication to intravenous contrast will be
 excluded. Patients will be stratified into study groups according to baseline AI:
 approximately half of patients will have no to mild AI at baseline and the other half will
 have moderate to severe AI at baseline. Anatomical measurements will be obtained from the 4D
 CTA scans and analyzed at each phase of the cardiac cycle, as well as longitudinally. The 4D
 CTA imaging and analysis will not impact medical care of the study participants; the
 anatomical measurements will be used in the future as evidence-based standards for
 determining valve repair candidacy for BAV patients with AI.
Inclusion Criteria:

 -  At least 18 years of age

 -  Documented bicuspid aortic valve identified via clinical imaging (e.g., CT, MRI, or
 echocardiogram) with minimal calcification at the time of enrollment

 -  Participant must sign the informed consent form

 Exclusion Criteria:

 -  Pregnancy (determined by point of care urine pregnancy test)

 -  Renal failure (estimated Glomerular Filtration Rate (eGFR) < 30), precluding them from
 receiving intravenous contrast)

 -  Documentation of previous intravenous contrast allergy (unless they are having a CT
 with steroid preparation as part of routine clinical care)

 -  Previous aortic valve replacement