Michael D. Hope1, Thomas A. Hope1, Alison K. Meadows1, Karen G. Ordovas1, David Saloner1, Marcus T. Alley2, Charles B. Higgins1
1Radiology, UCSF, San Francisco, CA, USA; 2Radiology, Stanford, Palo Alto, CA, USA
Abnormal systolic helical flow is seen with 4D Flow in the ascending thoracic aorta of patients with bicuspid aortic valve. Similar helical flow has been described in ascending aortic aneurysms associated with BAV, but we have demonstrated this flow pattern in three patients without aneurysm, suggesting that the pattern is not secondary to the dilated aorta, but may be implicated in the pathogenesis of aneurysm formation. The marked helical flow in the ascending aorta appears to be associated with eccentric flow jets in all 9 of our cases. Identification and characterization of eccentric flow jets in patients with BAV may help risk stratify for development of ascending aortic aneurysm and dissection.