Progressive Aortic Valve Stenosis: Is it all about the Calcium Deposition? - Abstract
Two patients with bicuspid aortic valve developed progressive dyspnea and severe stenosis during active surveillance. Patient 1 is a 67 year-old male with mild coronary artery disease. Prior to valve replacement, Computed Tomography (CT) demonstrated a heavily calcified valve (4,238 AU) with severely reduced leaflet excursion. Patient 2 is a 40 year-old female with no significant past medical history. CT showed moderately thickened aortic valve leaflets and minimal calcification (54 AU). In conclusion, hemodynamic assessment is a better indicator of severe aortic stenosis than CT calcium quantification, which may be limited in a subset of patients with bicuspid aortic valve.