Swanson Liam, Sivera Raphaël, Capelli Claudio, Alosaimi Abdulaziz, Mroczek Dariusz, Lam Christopher Z, Cook Andrew, Chaturvedi Rajiv R, Schievano Silvia
Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK.
Great Ormond Street Hospital for Children, London WC1N 3JH, UK.
J Cardiovasc Dev Dis. 2024 Oct 17;11(10):330. doi: 10.3390/jcdd11100330.
Assessment of the right ventricular outflow tract and pulmonary arteries (RVOT) for percutaneous pulmonary valve implantation (PPVI) uses discrete measurements (diameters and lengths) from medical images. This multi-centre study identified the 3D RVOT shape features prevalent in patients late after surgical repair of congenital heart disease (CHD). A 3D RVOT statistical shape model (SSM) was computed from 81 retrospectively selected CHD patients (14.7 ± 6.8 years) who required pulmonary valve replacement late after surgical repair. A principal component analysis identified prevalent shape features (modes) within the population which were compared with standard geometric measurements (diameter, length and surface area) and between sub-groups of diagnosis, RVOT type and dysfunction. Shape mode 1 and 2 represented RVOT size and curvature and tapering and length, respectively. Shape modes 3-5 related to branch pulmonary artery calibre, conical vs. bulbous RVOTs and RVOT curvature, respectively. Tetralogy of Fallot, transannular patch type and regurgitant RVOTs were larger and straighter while conduit and stenotic types were longer and more cylindrical than other subgroups. This SSM analysed the main 3D shape features present in a population of RVOTs, exploiting the wide 3D anatomical information provided by routine imaging. This morphological information may have implications for PPVI patient selection and device design.
经皮肺动脉瓣植入术（PPVI）中对右心室流出道和肺动脉（RVOT）的评估采用医学图像中的离散测量值（直径和长度）。这项多中心研究确定了先天性心脏病（CHD）手术修复后期患者中普遍存在的三维RVOT形状特征。从81例回顾性选择的CHD患者（14.7±6.8岁）中计算出三维RVOT统计形状模型（SSM），这些患者在手术修复后期需要进行肺动脉瓣置换。主成分分析确定了人群中普遍存在的形状特征（模式），并将其与标准几何测量值（直径、长度和表面积）进行比较，以及在诊断、RVOT类型和功能障碍的亚组之间进行比较。形状模式1和2分别代表RVOT的大小和曲率以及逐渐变细和长度。形状模式3-5分别与分支肺动脉口径、圆锥形与球根状RVOT以及RVOT曲率有关。法洛四联症、跨环补片类型和反流性RVOT比其他亚组更大更直，而人工管道和狭窄类型则更长且更呈圆柱形。该SSM分析了RVOT人群中存在的主要三维形状特征，利用了常规成像提供的广泛三维解剖信息。这种形态学信息可能对PPVI患者的选择和器械设计有影响。
