ABSTRACT
Objective To establish a quantitative analysis method for the anatomic structure of aortic root by real-time three-dimensional transesophageal echocardiography,and to explore the reliability and repeatability of this method.Methods Ninety five adult patients underwent RT-3DTEE were included in this study.Full-volume 3D images of aortic root were acquired and analyzed offline with QLab-3DQ (iE33, Philips).The three mutually perpendicular plane were determined.Results 1 )Aortic root:At the end of diastole,the diameter and area of coronary artery sinus bottoms level was 1 .84 cm and 3.45 cm2 ;the diameter and area of top commissural level was 2.97 cm and 7.77 cm 2 ;the diameter and area of sino-tubular junction level was 2.72 cm and 5.44 cm 2 .2)Aortic sinus:right coronary sinus was widest,left coronary sinus was the most stenosis(P 0.50).The measurement of each parameter,which analysis among different angles showed that 0° region were more accurate than others.Conclusions 3D quantitative analysis to aortic root can be established by full-volume RT-3DTEE images and has better reliability and repeatability.
ABSTRACT
Entrapment of the burr within calcified lesion is an uncommon, but serious complication during rotational atherectomy and usually needs surgical retrieval. We report a case series of this complication and also review the possible mechanisms, such as kokesi phenomenon or insufficient pecking motion with decreased rotational speed. We also review the potential techniques ever proposed to rescue this complica-tion percutaneously, including simple manual traction, balloon dilation to release the trap, snaring the burr as distal as possible for forceful local traction and wedging the burr with a child catheter to facilitate retrieval. Gentle pecking motion of the burr for sufficient ablation and shortening the run less than 15 s may avoid such complications. Interventional cardiologists using the rotablator should be familiar with the tips and tricks to avoid and rescue this complication.