Dynamic Volumetric Assessment of the Aortic Root: The Influence of Bicuspid Aortic Valve Competence

Autor: Nimesh D. Desai, Patrick Moeller, Michael Goodwin, Stuart J. Weiss, Prakash A. Patel, Natalie Yushkevich, Joseph H. Gorman, Eric K. Lai, Joseph E. Bavaria, Robert C. Gorman, Alison M. Pouch, Albert T. Cheung
Rok vydání: 2021
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Area change
Aortic root
Aortic Valve Insufficiency
Echocardiography
Three-Dimensional
030204 cardiovascular system & hematology
Volume change
Transesophageal echocardiogram
Severity of Illness Index
Article
03 medical and health sciences
0302 clinical medicine
Bicuspid aortic valve
Bicuspid Aortic Valve Disease
Internal medicine
Humans
Medicine
Ventriculoaortic junction
Vascular Calcification
Aorta
Echocardiography
Four-Dimensional
Aged
Retrospective Studies
medicine.diagnostic_test
Cardiac cycle
business.industry
Sinotubular Junction
Middle Aged
medicine.disease
030228 respiratory system
Aortic Valve
cardiovascular system
Cardiology
Female
Surgery
Cardiology and Cardiovascular Medicine
business
Echocardiography
Transesophageal
Zdroj: Ann Thorac Surg
ISSN: 0003-4975
Popis: BACKGROUND: Aortic root evaluation is conventionally based on two-dimensional measurements at a single phase of the cardiac cycle. This work presents an image analysis method for assessing dynamic three-dimensional changes in the aortic root of minimally calcified bicuspid aortic valves (BAVs) with and without moderate to severe aortic regurgitation. METHODS: The aortic root was segmented over the full cardiac cycle in three-dimensional transesophageal echocardiographic images acquired from 19 patients with minimally calcified BAVs and from 16 patients with physiologically normal tricuspid aortic valves (TAVs). The size and dynamics of the aortic root were assessed using the following image-derived measurements: absolute mean root volume and mean area at the level of the ventriculoaortic junction, sinuses of Valsalva, and sinotubular junction, as well as normalized root volume change and normalized area change of the ventriculoaortic junction, sinuses of Valsalva, and sinotubular junction over the cardiac cycle. RESULTS: Normalized volume change over the cardiac cycle was significantly greater in BAV roots with moderate to severe regurgitation than in normal TAV roots and in BAV roots with no or mild regurgitation. Aortic root dynamics were most significantly different at the mid-level of the sinuses of Valsalva in BAVs with moderate to severe regurgitation than in competent TAVs and BAVs. CONCLUSIONS: Echocardiographic reconstruction of the aortic root demonstrates significant differences in dynamics of BAV roots with moderate to severe regurgitation relative to physiologically normal TAVs and competent BAVs. This finding may have implications for risk of future dilatation, dissection, or rupture, which warrant further investigation.
Databáze: OpenAIRE
Externí odkaz: