Black David, Ahmad Zaheer, Lim Zek, Salmon Anthony, Veltdman Gruschen, Vettukattil Joseph
Congenital Cardiac Centre, Southampton University Hospital NHS trust, Tremona Road, Southampton, United Kingdom.
J Invasive Cardiol. 2012 Nov;24(11):594-8.
To review the use of three-dimensional echocardiography (3DE) with multiplanar reformatting (MPR) in children with congenital aortic stensosis undergoing percutaneous balloon aortic valvuloplasty to assess its accuracy in measuring the aortic valve annulus and any influence it may have on balloon sizing.
All percutaneous aortic balloon valvuloplasties performed from 01/01/2009 to 01/09/2011 were included in the study. All imaging performed for the procedure to determine the size of the aortic valve annulus and aid in balloon sizing was reviewed. The maximum diameter of the aortic valve annulus using two-dimensional echocardiography (2DE), 3DE with MPR, and angiography was recorded. The balloon size used in the procedure was recorded and the balloon to annulus ratio was calculated.
A total of 27 procedures were included in the study. Age varied from 1 day to 156 months (mean age, 53 months) and weight from 2.8-58 kg (mean weight, 18.6 kg). Fourteen patients had 3DE with MPR available for analysis. The 3DE with MPR measurement (13.36 ± 5.4 mm) was not different from angiography (13.54 ± 6.4 mm; P=.803).The 2DE measurement was significantly different from angiography (11.72 ± 5 mm; P<.005). The balloon to annulus ratio based on angiographic measurements did not differ significantly between the patients with 3DE MPR and those without (0.94 ± 0.095 vs 0.91 ± 0.1; P=.468).
3DE with MPR allows a more accurate assessment of the aortic valve annulus compared to 2DE, which may reduce the tendency to undersize balloon choice. 3DE with MPR did not significantly affect our balloon choice, which was largely based on angiographic measurements.
回顾三维超声心动图（3DE）联合多平面重建成像（MPR）在先天性主动脉瓣狭窄患儿经皮气囊主动脉瓣成形术中的应用，以评估其测量主动脉瓣环的准确性以及对球囊尺寸选择的影响。
纳入2009年1月1日至2011年9月1日期间所有进行的经皮主动脉球囊瓣膜成形术。回顾了为确定主动脉瓣环大小及辅助球囊尺寸选择而进行的所有成像检查。记录使用二维超声心动图（2DE）、3DE联合MPR及血管造影测量的主动脉瓣环最大直径。记录术中使用的球囊尺寸并计算球囊与瓣环比值。
本研究共纳入27例手术。年龄从1天至156个月（平均年龄53个月），体重从2.8 - 58 kg（平均体重18.6 kg）。14例患者有3DE联合MPR图像可供分析。3DE联合MPR测量值（13.36±5.4 mm）与血管造影测量值（13.54±6.4 mm；P = 0.803）无差异。2DE测量值与血管造影测量值有显著差异（11.72±5 mm；P < 0.005）。基于血管造影测量的球囊与瓣环比值，有3DE联合MPR的患者与没有该技术的患者之间无显著差异（0.94±0.095 vs 0.91±0.1；P = 0.468）。
与2DE相比，3DE联合MPR能更准确地评估主动脉瓣环，这可能会减少选择过小尺寸球囊的倾向。3DE联合MPR对我们的球囊选择没有显著影响，球囊选择主要基于血管造影测量。
