Perioperative Assessment of the Hemodynamic Ventriculoarterial Junction of the Aortic Root by Three-Dimensional Echocardiography.

Autor:	Burbano-Vera NH; Anesthesiology Institute, Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio; Anesthesiology Institute, Department of Pediatric Anesthesiology, Division of Pediatric Cardiac Anesthesiology, Cleveland Clinic, Cleveland, Ohio. Electronic address: burbann@ccf.org., Alfirevic A; Anesthesiology Institute, Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio., Bauer AM; Anesthesiology Institute, Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio., Wakefield BJ; Anesthesiology Institute, Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio., Najm HK; Congenital Valve Procedural Planning Program, Department of Pediatric Cardiology and Division of Pediatric Cardiac Surgery, Cleveland Clinic Children's, and the Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio; Heart, Vascular and Thoracic Institute, Department of Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio., Roselli EE; Heart, Vascular and Thoracic Institute, Department of Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio., Tretter JT; Congenital Valve Procedural Planning Program, Department of Pediatric Cardiology and Division of Pediatric Cardiac Surgery, Cleveland Clinic Children's, and the Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
Jazyk:	angličtina
Zdroj:	Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography [J Am Soc Echocardiogr] 2024 Jun; Vol. 37 (6), pp. 626-633. Date of Electronic Publication: 2024 Feb 07.
DOI:	10.1016/j.echo.2024.01.015
Abstrakt:	Improved strategies in aortic valve-preserving operations appreciate the dynamic, three-dimensional complexity of the aortic root and its valve. This depends not only on detailed four-dimensional imaging of the planar dimensions of the aortic root but also on quantitative assessment of the valvar leaflets and their competency. The zones of apposition and resulting hemodynamic ventriculoarterial junction formed in diastole determine valvar competency. Current understanding and assessment of this junction is limited, often relying on intraoperative direct surgical inspection. However, this direct inspection itself is limited by evaluation in a nonhemodynamic state with limited field of view. In this review, we discuss the anatomy of the aortic root, including its hemodynamic junction. We review current echocardiographic approaches toward interrogating the incompetent aortic valve for presurgical planning. Furthermore, we introduce and standardize a complementary approach to assessing this hemodynamic ventriculoarterial junction by three-dimensional echocardiography to further personalize presurgical planning for aortic valve surgery. Competing Interests: Conflicts of Interest None. (Copyright © 2024 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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