A 66 yo man with angina on effort, normal coronary angiograms and severe aortic stenosis .Cardiac MRI showed aortic valve stenosis and concentric hypertrophy of the left ventricle. In particular, steady-state free precession end-diastolic (A) and end-systolic (B) images at level of aortic valve plane showed a partial fusion of coronary cusps (three Valsava sinuses are clearly discernable)Aortic valve planimetry d (B) demonstrated an aortic valve area of 1 cm2 (0.5 cm2/m2).
Steady-state free precession 3-chamber image at end-systole ( C ) disclosed a riduced motionaortic valve cusps along with ‘signal void’ in the ascendending aorta (arrows), denoting an accelerated flowacross the valve. Finally, magnitude (D) and phase-contrast (E) images at the level of aortic valve plane revealeda peak velocity of 5.2 m/s (F).
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