CTICasesBicuspid Pulmonic Valve with Main Pulmonary Artery Enlargement
Imaging findings
Cardiac CT of a woman with aortic stenosis demonstrates a bicuspid pulmonic valve with fusion of the anterior and right leaflets. The main pulmonary artery is significantly enlarged, but this enlargement extends to the right and left pulmonary arteries and is not solely post-stenotic dilation, as there is no evidence of pulmonic stenosis or regurgitation by velocity measurements. She also has a very large ascending aorta.
Key takeaways
A bicuspid pulmonic valve, while often associated with other congenital heart diseases, can occur in isolation. Significant main pulmonary artery enlargement can be seen in conjunction with a bicuspid pulmonic valve, even without flow abnormalities like stenosis or regurgitation. The etiology of such isolated, non-stenotic PA enlargement with a bicuspid valve may be de novo and warrants consideration, particularly in the context of other cardiac anomalies like a tri-leaflet aortic valve and aortic stenosis.
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