Bicuspid Aortic Valve (BAV) patients often develop aortic dilation which can lead to life-threatening complications. Voxel-wise reverse flow was calculated to assess deranged flow in BAV patients with dilation and in healthy volunteers. In BAV patients, the mean reverse flow was significantly increased in the ascending aorta and aortic arch. The reverse flow volume (volume with reverse flow>0.03mL/cycle) was also increased. Linear regression demonstrated that these reverse flow metrics were significant contributors to mid-ascending aorta diameter even when age was accounted for. We demonstrated that reverse flow is a significant component of deranged flow in BAV disease.
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