Perioperative Hemodynamic Changes in the Thoracic Aorta in Patients With Aortic Valve Stenosis: A Prospective Serial 4D-Flow MRI Study

Autor: Kei Takase, Ichiro Yoshioka, Hiroki Kamada, Masanori Nakamura, Ko Sakatsume, Shunichi Ishida, Yohsuke Imai, Hideki Ota, Wenyu Sun, Yoshikatsu Saiki
Rok vydání: 2020
Předmět:
Male
Patient-Specific Modeling
Pulmonary and Respiratory Medicine
Aortic arch
medicine.medical_specialty
Perfusion Imaging
Aorta
Thoracic
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Bicuspid aortic valve
Aortic valve replacement
Predictive Value of Tests
medicine.artery
Internal medicine
Ascending aorta
medicine
Humans
Thoracic aorta
Prospective Studies
Aortic valve regurgitation
Aged
Aged
80 and over
Heart Valve Prosthesis Implantation
Aorta
business.industry
Hemodynamics
Models
Cardiovascular
Reproducibility of Results
Aortic Valve Stenosis
General Medicine
medicine.disease
Treatment Outcome
030228 respiratory system
Regional Blood Flow
Aortic Valve
Aortic valve stenosis
cardiovascular system
Cardiology
Female
Surgery
Cardiology and Cardiovascular Medicine
business
Blood Flow Velocity
Magnetic Resonance Angiography
Zdroj: Seminars in Thoracic and Cardiovascular Surgery. 32:25-34
ISSN: 1043-0679
DOI: 10.1053/j.semtcvs.2019.07.006
Popis: This study investigated hemodynamic changes in the thoracic aorta and aortic arch branches before and after aortic valve replacement (AVR) by 4D-flow MRI in patients with aortic valve stenosis (AS). Thoracic 4D-flow MRI was performed in 10 AS patients before and after AVR (mean 27 ± 1.9 days). Fifteen aortic planes and 3 aortic arch branches planes were set to evaluate the mean volume flow rate in each plane during a cardiac cycle and the angle between the main flow direction in a specified plane and the axial direction of the aorta. We also focused on the distribution and magnitude of helicity density to evaluate the flow complexity. A significant increase in the volume flow rate after AVR was found in the ascending aorta (before 59.2 ± 8.7 mL/s vs after 77.3 ± 6.2 mL/s, P0.05) and the aortic arch branches (before 26.5 ± 2.8 mL/s vs after 35.8 ± 3.3 mL/s, P0.001). The flow angle significantly decreased in the ascending aorta (before 39.2 ± 2.7 degree vs after 25.2 ± 1.7°, P0.0001) and the arch aorta (before 19.3 ± 2.0 degree vs after 13.4 ± 0.9°, P0.001). The volume flow rate in the ascending aorta and the arch branches increased within 1 month after AVR, showing an increased blood supply to the upper body, including to the brain. The postoperative change was accompanied with an increased blood flow in the ascending aorta and a decreased flow complexity proximal to the arch branches.
Databáze: OpenAIRE
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