Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
Circ J. 2010 Nov;74(12):2649-57. doi: 10.1253/circj.cj-10-0540. Epub 2010 Nov 12.
Precise evaluation of the aortic root geometry prior to transcatheter aortic valve implantation is important for procedural success in patients with aortic stenosis (AS). To determine the potential for 3-dimensional transesophageal echocardiography (3DTEE), the aims of the present study were: (1) to assess the accuracy of 3DTEE measurements of the aortic root using multidetector computed tomography (MDCT) as a reference, and (2) to examine whether aortic root geometry differs between patients with and without AS.
3DTEE and contrast-enhanced MDCT were performed in 35 patients. Multiplanar reconstruction was used to measure the left ventricular outflow tract (LVOT) and aortic annulus diameter/area, aortic valve area (AVA), and distances between the annulus and coronary artery ostium. The same 3DTEE measurements were performed in patients with (n=71) and without AS (n=80). Aortic annular and LVOT areas measured by 3DTEE were slightly but significantly smaller compared with values obtained with MDCT. Both methods revealed that the aortic annulus and LVOT have an oval shape. Aortic annular and LVOT area, AVA and the distances between the aortic annulus and the coronary ostia correlated well between the 2 modalities. Only minor differences in aortic root geometry were observed between patients with AS and those without.
The geometry of the aortic annulus can be reliably evaluated using 3DTEE as an alternative to MDCT for the assessment of aortic root.
在经导管主动脉瓣植入术（TAVI）前，对主动脉根部几何形状进行精确评估对于主动脉瓣狭窄（AS）患者的手术成功至关重要。为了确定三维经食管超声心动图（3DTEE）的潜力，本研究的目的是：（1）评估使用多排螺旋计算机断层扫描（MDCT）作为参考的 3DTEE 测量主动脉根部的准确性，以及（2）检查主动脉根部几何形状是否在有和无 AS 的患者之间存在差异。
对 35 例患者进行了 3DTEE 和对比增强 MDCT 检查。多平面重建用于测量左心室流出道（LVOT）和主动脉瓣环直径/面积、主动脉瓣口面积（AVA）以及瓣环和冠状动脉开口之间的距离。在有（n=71）和无 AS（n=80）的患者中进行了相同的 3DTEE 测量。3DTEE 测量的主动脉瓣环和 LVOT 面积略小于 MDCT 获得的值，但差异有统计学意义。两种方法均显示主动脉瓣环和 LVOT 呈椭圆形。主动脉瓣环和 LVOT 面积、AVA 以及主动脉瓣环和冠状动脉开口之间的距离在两种方法之间相关性良好。仅观察到 AS 患者和无 AS 患者的主动脉根部几何形状存在微小差异。
3DTEE 可作为 MDCT 的替代方法，用于评估主动脉根部，可靠地评估主动脉瓣环的几何形状。
