Giant pulmonary artery in a 51 year old male with severe aortic stenosis
  This 51 year old subject suffers from Angina. Echocardiography revealed a severe aortic stenosis due to a heavily degenerated, thickened and calcified bicuspid aortic valve. There was severe concentric hypertrophy of the left ventricle. Further, there was suspicion of a ventricular septal defect and a pulmonic valve anomaly. The patient was then referred for further diagnostic work up to our CMR Center.
   
As usual in our institution, a rapid echocardiography was performed in order to get a link to the view of the referring cardiologist.

Echocardiography showed a severe concentric hypertrophy and a grossly thickened aortic valve with severely reduced motility of all leaflets. Number of cusps could not be determined.
   
The pulmonic valve appeared normal. Peak velocity was somewhat increased.
   
Using an atypical apical view, the right ventricular infundibulum and outflow tract could be visualized. There was no ventricular septal defect.
   
Using the same atypical apical view, echo color doppler showed a small pulmonic valve insufficiency.
   
CMR showed a massive dilation of the pulmonary trunc (59x 61 mm)
   
  CMR showed a concentric left ventricular hypertrophy (Cine SA), a normal left ventricular function in the 4 Chamber View and in the 2 Chamber View, and a severly dilated pulmonary trunc without pulmonic stenosis (Cine RVOT) and a normal pulmonic valve. Further, a coronal angiogram of the large thoracic vessels was performed (View Cine). There was no intrathoracic shunt.