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: |
|