Chen Yang, Sun Baihua, Wang Zhongyu, Wang Moyang, Zhang Hongliang, Niu Guannan, Zhao Zhenyan, Feng Dejing, Zhang Pinghai, Jiang Zhibo, Yuan Junhua, Song Junxian, Wu Yongjian
Coronary Heart Disease Center, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Department of Cardiology, Peking University People's Hospital, Beijing, 100044, China.
BMC Med Imaging. 2025 Aug 12;25(1):326. doi: 10.1186/s12880-025-01867-y.
Transcatheter aortic valve replacement (TAVR) is a well-established technique for the treatment of aortic stenosis (AS). However, due to the complex anatomical features of the aortic root, the risk of vascular injury caused by operation under the condition of anatomical variations of the aortic root is high, and there is a lack of studies on the anatomical features of the aortic root on CT before TAVR. Therefore, this study will preliminarily summarize anatomical features of aortic root in patients with aortic stenosis treated by TAVR.
A retrospective study was conducted at a single center, involving 60 patients with symptomatic severe AS treated TAVR between September 2022 and December 2022. Baseline patient information, CT measurements of aortic root anatomical characteristics, and associated risks were analyzed.
The mean age of the 60 patients was 77.72 ± 4.33 years, with 39 males (65.00%). The left ventricular ejection fraction was 65.46 ± 13.92%. Valve morphology included 38 cases (63.30%) of tricuspid valves and 22 cases (36.70%) of bicuspid valves. Common anatomical risks identified were acute aortic arch (18.33%), a short ascending aorta (10.00%, 8.33%, 16.67%, 15.00%), ascending aortic dilation (3.33%), a transverse heart (28.33%), cardiac anteversion (68.33%), a short left ventricle (5.00%), and a small left ventricle (5.00%).
Preoperative cardiac CT scans detect aortic root morphological angle abnormalities in TAVR patients. Angular dimensions of the aortic root show considerable variability among patients, which may have procedural implications for TAVR.
经导管主动脉瓣置换术（TAVR）是治疗主动脉瓣狭窄（AS）的成熟技术。然而，由于主动脉根部解剖结构复杂，在主动脉根部解剖变异情况下手术导致血管损伤的风险较高，且缺乏TAVR术前CT对主动脉根部解剖特征的研究。因此，本研究将初步总结经TAVR治疗的主动脉瓣狭窄患者主动脉根部的解剖特征。
在单一中心进行回顾性研究，纳入2022年9月至2022年12月期间接受TAVR治疗的60例有症状的重度AS患者。分析患者基线信息、主动脉根部解剖特征的CT测量结果及相关风险。
60例患者的平均年龄为77.72±4.33岁，男性39例（65.00%）。左心室射血分数为65.46±13.92%。瓣膜形态包括三尖瓣38例（63.30%）和二尖瓣22例（36.70%）。确定的常见解剖风险有急性主动脉弓（18.33%）、升主动脉短（10.00%、8.33%、16.67%、15.00%）、升主动脉扩张（3.33%）、横位心（28.33%）、心脏前倾（68.33%）、左心室短（5.00%）和左心室小（5.00%）。
术前心脏CT扫描可检测TAVR患者主动脉根部形态角度异常。主动脉根部的角度尺寸在患者之间存在相当大的变异性，这可能对TAVR手术有影响。
