Comparison of Aortic Valve Calcification Frequency Between Bicuspid Valve and Tricuspid Valve Insight from Computed Tomography

Abstract

Background: Aortic Valve Calcification (AVC) is a progressive pathological process commonly associated with aortic stenosis. Variations in calcification between bicuspid aortic valves (BAV) and tricuspid aortic valves (TAV) are clinically relevant, as they affect disease progression, diagnostic accuracy, and therapeutic planning. Non-invasive imaging, particularly computed tomography (CT), offers reliable assessment of calcification burden and valve morphology. This study aimed to compare the frequency and severity of AVC in BAV and TAV using CT angiography.

Methods: A six-month cross-sectional, comparative, and observational study was carried out at the Radiology Department of the Islamabad Diagnostic Center, Faisalabad. Sixty-one participants (aged 20–60 years) were recruited using convenience sampling according to predefined inclusion and exclusion criteria. ECG-gated CT angiography was performed with a 128-slice dual-source CT scanner. Calcification volumes were measured using advanced 3D post-processing software with automated and manual tools. Demographic and clinical information was collected through structured questionnaires. Results: Among 61 participants, females comprised 62.3%, with the largest group aged 20–30 years. Familiarity with AVC was reported by 62.3% of respondents, and 75% indicated routine use of AVC assessment in clinical practice. Regarding utility, 57.4% considered AVC evaluation very or quite effective, while 50.8% believed it had a significant or transformative role in clinical decision-making. Statistically significant associations (p < 0.01) were observed between knowledge, perceived effectiveness, and clinical application of AVC assessment. Conclusion: CT-based AVC assessment provides critical information on valve calcification patterns, enabling differentiation between BAV and TAV. These findings support its role in enhancing diagnostic precision and guiding optimal patient management.

Keywords: Aortic Valve Calcification, Aortic Stenosis, Bicuspid Aortic Valve, Tricuspid Aortic Valve, CT Angiography