Abnormal aortic flow profiles persist after aortic valve replacement in the majority of patients with aortic valve disease: how model-based personalized therapy planning could improve results. A pilot study approach
| Autor: | Leonid Goubergrits, Christoph Knosalla, Felix Berger, Marcus Kelm, Sarah Nordmeyer, Daniel Lehmann, Chong-Bin Lee, Siegfried Kropf, Pavel Yevtushenko, Volkmar Falk, Florian Hellmeier, Titus Kuehne |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Pilot Projects 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Aortic valve replacement Interquartile range Internal medicine medicine.artery medicine Humans Heart Valve Prosthesis Implantation Aorta medicine.diagnostic_test business.industry Aortic valve disorder Magnetic resonance imaging General Medicine Blood flow medicine.disease Aortic Valve Disease Clinical trial Aortic Valve Heart Valve Prosthesis Cohort Cardiology Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 57:133-141 |
| ISSN: | 1873-734X 1010-7940 |
| DOI: | 10.1093/ejcts/ezz149 |
| Popis: | OBJECTIVES Complex blood flow profiles in the aorta are known to contribute to vessel dilatation. We studied flow profiles in the aorta in patients with aortic valve disease before and after surgical aortic valve replacement (AVR). METHODS Thirty-four patients with aortic valve disease underwent 4-dimensional velocity-encoded magnetic resonance imaging before and after AVR (biological valve = 27, mechanical valve = 7). Seven healthy volunteers served as controls. Eccentricity (ES) and complex flow scores (CFS) were determined from the degree of helicity, vorticity and eccentricity of flow profiles in the aorta. Model-based therapy planning was used in 4 cases to improve in silico postoperative flow profiles by personalized adjustment of size, rotation and angulation of the valve as well as aorta diameter. RESULTS Patients with aortic valve disease showed more complex flow than controls [median ES 2.5 (interquartile range (IQR) 2.3–2.7) vs 1.0 (IQR 1.0–1.0), P CONCLUSIONS Abnormal flow profiles in the aorta more frequently persist after surgical AVR. Model-based therapy planning might have the potential to optimize treatment for best possible individual outcome. Clinical trial registration number clinicaltrials.gov NCT03172338, 1 June 2017, retrospectively registered; NCT02591940, 30 October 2015, retrospectively registered. |
| Databáze: | OpenAIRE |
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