Computed Tomography Helps to Plan Minimally Invasive Aortic Valve Replacement Operations
| Autor: | Kamil Fijorek, Paweł Kruszec, Robert Musiał, Dariusz Plicner, Jarosław Stoliński, Grzegorz Grudzień, Janusz Andres |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Thorax Aortic valve Male medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Aortic valve replacement law medicine.artery Multidetector Computed Tomography medicine Cardiopulmonary bypass Second intercostal space Humans Minimally Invasive Surgical Procedures Aorta Aged Aged 80 and over Heart Valve Prosthesis Implantation business.industry Middle Aged medicine.disease Surgery Femoral Artery medicine.anatomical_structure 030228 respiratory system Median sternotomy Aortic Valve cardiovascular system Female Intercostal space Cardiology and Cardiovascular Medicine business |
| Popis: | Background This study evaluated the role of multidetector computed tomography (MDCT) in preparation for minimally invasive aortic valve replacement (MIAVR). Methods An analysis of 187 patients scheduled for MIAVR between June 2009 and December 2014 was conducted. In the study group (n = 86), MDCT of the thorax, aorta, and femoral arteries was performed before the operation. In the control group (n = 101), patients qualified for MIAVR without receiving preoperative MDCT. Results The surgical strategy was changed preoperatively in 12.8% of patients from the study group and in 2.0% of patients from the control group ( p = 0.010) and intraoperatively in 9.9% of patients from the control group and in none from the study group ( p = 0.002). No conversion to median sternotomy was necessary in the study group; among the controls, there were 4.0% conversions. On the basis of the MDCT measurements, optimal access to the aortic valve was achieved when the angle between the aortic valve plane and the line to the second intercostal space was 91.9 ± 10.0 degrees and to the third intercostal space was 94.0 ± 1.4 degrees, with the distance to the valve being 94.8 ± 13.8 mm and 84.5 ± 9.9 mm for the second and third intercostal spaces, respectively. The right atrium covering the site of the aortotomy was present in 42.9% of cases when MIAVR had been performed through the third intercostal space and in 1.3% when through the second intercostal space ( p = 0.001). Conclusions Preoperative MDCT of the thorax, aorta, and femoral arteries makes it possible to plan MIAVR operations. |
| Databáze: | OpenAIRE |
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