Impact of Wall Shear Stress and Flow Displacement on Aortic Root Dilation in Bicuspid Aortic Valve Patients with Varied Regurgitation Severity

Motivation: Congenital bicuspid aortic valve (BAV) effects and its associated lesions on hemodynamic alterations, leading to aortic root dilation as the most severe form of aortopathy, remains unexplored. Goal(s): We aimed to examine the relationship between BAV phenotypes, considering various regurgitation severities, and aortic root dilation by analyzing abnormal wall shear stress (WSS) and normalized flow displacement (NFD) related to retrograde and anterograde flow jets. Approach: We utilized time-resolved three-dimensional phase contrast MRI to measure these velocity-derived flow biomarkers in healthy and BAV cohorts. Results: WSS proved a more sensitive and reliable metric than NFD in distinguishing BAV from healthy controls. Impact: Validating and quantifying advanced flow biomarkers in the aortic root due to its different biomechanical properties could enhance risk assessment, prognosis, and prevention of clinical complications in BAV patients with secondary valvular insufficiency.