Bevilacqua Carmine, Eibel Sarah, Foldyna Borek, Knoefler Thomas, Lehmkuhl Lukas, Gutberlet Matthias, Mukherjee Chirojit, Seeburger Joerg, Davierwala Piroze, Ender Joerg
Department of Anesthesiology and Intensive Care Medicine, Heart Center Leipzig, Struempellstr. 39, 04289, Leipzig, Germany.
Department of Anesthesiology, University Medical Center, Johannes - Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany.
Int J Cardiovasc Imaging. 2017 Nov;33(11):1703-1710. doi: 10.1007/s10554-017-1162-7. Epub 2017 May 13.
Iatrogenic injury to the circumflex artery (Cx) due to its close proximity to the mitral annulus is a rare but dreadful complication that can occur during mitral valve repair. The aim of our study was to compare multiple measurements of the Cx datasets, obtained by real time three-dimensional transesophageal echocardiography (RT3D TEE) and corresponding measurements assessed in multi-planar three-dimensional images acquired by multidetector computed tomography (MDCT). Preoperative RT3D TEE and MDCT datasets of 25 patients who had previously undergone minimally invasive mitral valve surgery were retrospectively analyzed. The vessel diameter and the horizontal as well as vertical distances from the center of the Cx to the mitral valve annulus were measured. Horizontal as well as vertical Cx distances showed a strong correlation between measurements of RT3D TEE and MDCT whereas the measurements of the Cx diameter showed no correlation. Measurements of horizontal and vertical distances of the Cx to the mitral annulus can be performed using RT3D TEE and show good correlation with MDCT-based measurements.
由于回旋支动脉（Cx）紧邻二尖瓣环，二尖瓣修复术中发生医源性回旋支动脉损伤是一种罕见但可怕的并发症。本研究的目的是比较经实时三维经食管超声心动图（RT3D TEE）获得的Cx数据集的多项测量值，以及在多排螺旋计算机断层扫描（MDCT）获取的多平面三维图像中评估的相应测量值。对25例先前接受过微创二尖瓣手术患者的术前RT3D TEE和MDCT数据集进行回顾性分析。测量血管直径以及Cx中心到二尖瓣环的水平和垂直距离。Cx的水平和垂直距离在RT3D TEE和MDCT测量之间显示出很强的相关性，而Cx直径的测量值则无相关性。使用RT3D TEE可以测量Cx到二尖瓣环的水平和垂直距离，并且与基于MDCT的测量结果具有良好的相关性。
