ABSTRACT
Objective To study the morphologic and functional changes of the aortic‐mitral valve coupling ( AMC) after surgical aortic valve replacement ( SAVR) or transcatheter aortic valve implantation ( T AVI ) in patients with severe aortic stenosis ( AS) using three‐dimensional transesophageal echocardiography ( 3D‐T EE) . Methods Ninty‐three severe AS patients were chosed as AS group in which 43 cases underwent SAVR and 50 cases underwent T AVI . T EE was performed before and after operation . T hirty‐one age‐and gender‐matched patients who underwent 3D‐T EE for exclusion of intracardiac thrombus were selected as control group . Cardiovascular quantitative analysis software was used to measure the parameters of aortic valve ,mitral valve and AMC in the the control group ,the SAVR group and the T AVI group before and after operation . Results ① Compared with control group ,the antero posterior ( AP ) diameter of mitral value in AS group increased ,the ellipticity of mitral valve decreased ,the height of the mitral annulus increased ( all P＜ 0 .05 ) . T he open area of aortic valve decreased ,the aortic regurgitation area ,aortic regurgitant flow velocity and the diameter of the aortic annulus increased( all P ＜0 .05) . T here was no statistical difference in aortic‐mitral valvular angle ( AM A ) and other parameters( all P ＞0 .05) . ②After SAVR ,the anterolateral‐posteromedial diameter ,AP diameter ,perimeter and area of mitral valve decreased ,the ellipticity of mitral valve increased( all P ＜0 .05) . T he aortic valve opening area increased ,the aortic regurgitation area and aortic regurgitant flow velocity decreased ( all P ＜ 0 .05 ) . T here was no statistical difference in AM A and other parameters( all P ＞0 .05) . ③After TAVI ,the AP diameter ,height , perimeter and area of mitral valve decreased ,the ellipticity of mitral valve increased ( all P ＜ 0 .05 ) . The aortic valve opening area increased ,the aortic regurgitation area ,aortic regurgitant flow velocity and the diameter of the aortic annulus decreased ( all P ＜ 0 .05 ) . T here was no statistical difference in AM A and other parameters( all P ＞0 .05) . Conclusions After SAVR and T AVI ,the anatomy and function of AMC in patients with severe AS changed to varying degrees after operation . It demonstrates that the impacts of both AS and repairment of AS on the mitral valve were . In addition ,after SAVR and T AVI ,the geometry and function of aortic and mitral valves of the patients recovered to some degrees .