Congenital Aortic Valve Abnormalities
There are several congenital malformations of the aortic valve which include unicuspid, bicuspid and quadricuspid valves. Bicuspid aortic valve is the most common congenital abnormality of the aortic valve affecting 2% of the general population. Although standard 2D echocardiography can accurately delineate the aortic valve morphology in most cases as tricuspid versus bicuspid, the diagnosis can be difficult in calcified aortic valves and in cases of bicuspid aortic valve when a raphe that mimics a commissure. The ability of 3D echocardiography to visualize the aortic valve in en face view from the aorta provides direct visualization of the aortic valve cusp margins and commissures (Figure 2, Movie 1).The diagnostic accuracy of 3D TEE for bicuspid aortic valve has been validated against anatomic examination of autopsy specimens.