Causal Relationship of Transverse Left Ventricular Band and Bicuspid Aortic Valve

Abstract

Objectives: Bicuspid aortic valve is the most common congenital lesion found in adults. It is can be seen in combination with a transverse left ventricular (LV) band. We aimed to find an essential relationship between the presence of transverse ventricular band and bicuspid aortic valve. Methods: 13 patients with transverse left ventricular band were investigated during a 6 month period from January 2019 to July 2019. LV band thickness and gradients at the site of the LV band were evaluated as part of its effect on LV hemodynamics. Morphology of aortic valve and LV outflow tract gradients were assessed. We aimed to establish the presence of robust LV band as a surrogate marker for bicuspid aortic valve and evaluate the effect of LV band on LV hemodynamics. Results: Mean age of study population was 41yrs. Majority had bicuspid aortic valve(n=11). Average thickness of transverse band was 6.2mm and average mean aortic gradient was4mmHg. Sequestration of blood was noted at the level of transverse band in all the patients with 2 separate jets at LVOT. Anterolateral jet was deflected from transverse band and showed higher velocity in comparison to the other jet, causing turbulence at the bicuspid aortic valve. No co-relation was found between the thickness of transverse band and aortic valve gradient. Conclusion: Presence of a robust transverse LV band can serve as a surrogate marker for bicuspid aortic valve.

Keywords: Bicuspid aortic valve ; aortic stenosis