Heart<unk>  anatomy. Fusion of aortic<unk>  leaflets occurs most commonly (≈80%) between the right coronary and left coronary leaflets (RL), which are the anterior leaflets of the aortic<unk> . Fusion also occurs between the right coronary and noncoronary leaflets (RN, ≈17%), and least commonly between the noncoronary and left coronary leaflets (≈2%). In comparison to other fusion patterns, RN leaflet fusion has a stronger association with future complications such as aortic<unk>  regurgitation and stenosis. However, all fusion patterns associate with a specific area or areas of dilated enlargement in either the root of the ascending aorta, the ascending aorta, or the transverse aortic arch. Hemodynamics Identifying hemodynamic patterns in the aorta after left ventricle systole aids in predicting consequential complications of<unk> . The patient-specific risk of developing complications such as aortic aneurysms is dependent on the particular aortic leaflet fusion pattern, with each pattern varying in 4D MRI measurements of wall shear stress (WSS), blood flow velocity, asymmetrical flow displacement and flow angle of the aorta.<unk>  outflow is helical and occurs at high velocities (>1 m/s) throughout the ascending aorta. This is potentially more damaging to the aorta in comparison to the streamline flow and short-lived burst of high velocity at the beginning of the aorta, as seen within a healthy tricuspid<unk> . This eccentric outflow from the<unk>  results in blood hitting and reflecting off the aortic wall in a non-streamline fashion. The specific zones where blood hits is dependent on the varying<unk>  leaflet fusion patterns and consequently correlates with increases in WSS. WSS measurements in RL fusion indicate an increase in pressure applied predominantly to the right-anterior side of the vessel wall, while RN fusion increases WSS on the right-posterior wall. The resulting rise in WSS is supported by the asymmetrical displacement of blood flow produced by an increased angle of outflow from the<unk> . Displacement is measured as the distance in millimeters from the center of the aorta to the center of the high velocity outflow. Blood does not flow centrally through the aorta in<unk> , but along the right-anterior and right-posterior vessel wall for RL and RN leaflet fusion respectively. Aortic disease Identification of hemodynamics for RL, RN, and left coronary and noncoronary leaflet fusion patterns enables detection of specific aortic regions susceptible to dysfunction and the eventual development of disease. Specifically, RL and RN fusion patterns are more likely to develop into these aortic disease states. The blood flow information associated with RL fusion causes dilation of the mid-ascending aorta, while RN fusion is associated with dilation in the root, distal ascending aorta and transverse arch.<unk>  helical and high velocity outflow patterns are consistent with aortic dilation hemodynamics seen in those with tricuspid aortic<unk> s. However, it is the increase and variance in WSS and flow displacement in<unk>  that demonstrate the importance of aortic leaflet morphology. Flow displacement measurements taken from 4D MRI may be best for detecting irregularities in hemodynamics. Displacement measurements were highly sensitive and distinguishable between different<unk>  morphologies. Hemodynamic measurements from 4D MRI in patients with<unk>  are advantageous in determining the timing and location of repair surgery to the aorta in aortopathy states. Most patients with<unk>  whose<unk>  becomes dysfunctional will need careful follow-up and potentially<unk>  replacement at some point in life. Regular EchoCG and MRI may be performed.If the<unk>  is normally functioning or minimally dysfunctional, average lifespan is similar to that of those without the anomaly.
Bicuspid aortic valve
Quadricuspid aortic valve
Flutter valve
Mitral annular calcification
Supravalvular aortic stenosis
Accessory auricle
Overriding aorta
Mitral annular disjunction