Operative Unit of Cardiac Surgery and.
Ann Cardiothorac Surg. 2012 Jul;1(2):245-56. doi: 10.3978/j.issn.2225-319X.2012.06.13.
Transcatheter aortic valve implantation (TAVI) is a valuable alternative for aortic valve replacement in selected high-risk candidates. Accurate preoperative assessment of the aortic annular dimensions is crucial for the success of TAVI, since choice of an incorrectly sized prosthesis may result in catastrophic complications. These complications include annular rupture and coronary arterial obstruction, if the prosthesis is too big, or prosthesis migration and severe paravalvular leakage, if the prosthesis is too small. According to current recommendations, the choice of prosthesis size is based on transoesophageal echocardiography (TEE) measurements. However, TEE results are dependent on operator experience. Moreover, recent research has shown that TEE can significantly underestimate annular dimensional measurements. Alternative sizing methods based on Multidetector Computed Tomography (MDCT) or manometry during balloon aortic valvuloplasty have therefore been developed. We present a brief overview of the imaging modalities available for preoperative assessment of annular size and discuss their potential advantages and limitations.
经导管主动脉瓣置换术（TAVI）是一种有价值的选择，可用于特定高危患者的主动脉瓣置换。在 TAVI 中，准确的术前评估主动脉瓣环尺寸至关重要，因为选择尺寸不正确的假体可能会导致灾难性的并发症。如果假体过大，可能会导致瓣环破裂和冠状动脉阻塞，如果假体过小，可能会导致假体迁移和严重瓣周漏。根据目前的建议，假体尺寸的选择基于经食管超声心动图（TEE）测量。然而，TEE 结果取决于操作者的经验。此外，最近的研究表明，TEE 可能会显著低估瓣环尺寸的测量值。因此，已经开发了基于多排螺旋 CT（MDCT）或球囊主动脉瓣成形术期间的测压的替代尺寸测量方法。我们简要概述了用于术前评估瓣环大小的成像方式，并讨论了它们的潜在优势和局限性。
