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. 2023 May 11;12(3):194–212. doi: 10.21037/acs-2022-avs1-14

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2023 Annals of Cardiothoracic Surgery. All rights reserved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

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Three-dimensional volume acquisition with multiplanar reconstruction allows for assessment of the quality of cusp tissue. (A) Example of systolic restrictive cusp motion: the tips of the cusps (green arrows) do not cross the virtual line (red dotted line) between two commissures in end-systole due to a root dilatation. (B) Example of thickening and calcification (red arrow) of the free margin, reducing the valve opening. (C) Example of a small calcification spot trapped into the non-fused cusp of a bicuspid aortic valve assessed by MPR (red arrow). MPR, multiplanar reconstruction.