Abstract #4448

Hemodynamic Outcome in Patients After Bicuspid and Tricuspid Valve Sparing Aortic Root Repair: A 4D Flow MRI Study

Edouard Michel Semaan¹, Michael Markl¹, Bradley D. Allen¹, Alex Baker¹, Chris Malaisrie², Patrick McCarthy³, James C. Carr⁴, Jeremy D. Collins⁴

¹Radiology Department, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States; ²Surgery Department, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States; ³Surgery-Cardiac Surgery Department, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States; ⁴Radiology Department, Northwestern University, Chicago, IL, United States

This study evaluates the impact of aortic root repair on aortic hemodynamic flow in subjects with bicuspid and tricuspid aortic valve morphology without stenosis or significant insufficiency using 4D flow MRI. Aortic root repair results in a more homogeneous flow profile, reduced helical flow patterns, and resolution of forward flow jets impacting the aortic wall compared to control subjects matched with pre-surgical thoracic aortic aneurysm size, age, and aortic valve morphology. These changes occur at the expense of increased peak systolic velocities and regurgitation; the long-term impact of these changes on vascular physiology is unknown.