Percent Deviation from Midline Coaptation- When to Suspect Bicuspid Aortic Valve

Background: Bicuspid aortic valve (BAV) is typically diagnosed by visualization of aortic valve leaflet opening during systole in parasternal short axis (PSAX) echocardiographic images. The leaflets are often seen poorly in PSAX view due to suboptimal acoustic windows or poor imaging techniques but are usually seen well in parasternal long axis (PLAX) view. Although the eccentric leaflet coaptation in PLAX view has been previously described the degree of eccentricity that should alert clinicians of the presence of BAV is not established in children. The …