Evaluation of causal heart diseases in cardioembolic stroke by cardiac computed tomography

Figure 14  Aortic stenosis. A man in his seventies with chronic renal failure requiring hemodialysis and aortic stenosis underwent cardiac computed tomography (CCT) on two occasions to evaluate obstructive coronary artery disease. A: 19 years after initiation of hemodialysis. Left: Short axis reformatted CCT image in diastole shows tricuspid aortic valve with calcification. Middle: Aortic valve calcium score (AVCS) by Agatston method and aortic valve calcium volume were 2534 and 1988 mm³, respectively. Right: Quantification of aortic valve area (AVA) by planimetry is 1.14 cm²; B: 24 years after initiation of hemodialysis. Left: Extent of aortic valve calcification has increased. Middle: AVCS by Agatston method and aortic valve calcium volume were 5888 and 4447 mm³, respectively. Right: Quantification of AVA by planimetry is 0.65 cm²; C: Surgical aortic valve replacement was performed after second CCT examination. Gross specimen of surgically resected aortic valve is shown.