The most common association of adult-type aortic coarctation is bicuspid aortic valves. Cardiac MRI is advantageous for imaging aortic coarctation as it can directly demonstrate an associated bicuspic aortic valve, any accompanying valve dysfunction, and secondary effects upon the left ventricle eg concentric hypertrophy.
It is important to recognize that patients with bicuspid aortic valves have an associated aortopathy of the ascending aorta, irrespective of whether the latter is dilated. The media is abnormal and is a predisposing factor for dilatation and dissection. Other complications of bicuspid aortic valves are aortic stenosis, aortic regurgitation and endocarditis.