Real-time three-dimensional transesophageal echocardiography automated measuring of aortic annulus before transcatheter aortic valve replacement / 中国医学影像技术

Objective: To explore the feasibility and accuracy of 3D transesophageal echocardiography (3D-TEE) automated measuring of aortic annulus before transcatheter aortic valve replacement (TAVR). Methods: The area, perimeter, maximal diameter and minimum diameter of aortic annulus were measured with 3D-TEE and multi-detector CT (MDCT) in 21 patients who underwent TAVR. The difference and correlation between the above parameters measured with 3D-TEE and MDCT were analyzed. The time for measuring aortic annulus with 3D-TEE was recorded. Results: The area, perimeter, maximal diameter and minimum diameter of aortic annulus measured with 3D-TEE were (445.74±62.60)mm2, (76.16±5.30)mm, (26.29±1.97)mm and (21.40±1.68)mm, respectively, with MDCT were (456.85±75.70)mm2, (77.17±5.90)mm, (26.76±2.83)mm, (20.98±1.76)mm, respectively (all P>0.05), all had high correlations (r=0.89, 0.91, 0.85, 0.79, all P<0.01). The analyzed time was (1.54±0.21)min with automated 3D-TEE. Conclusion: Automated measurement of aortic annular with 3D-TEE before TAVR is feasible, accuracy and rapid, which may replace MDCT for TAVR in clinical setting.

Aortic Valve Replacement with Annular Enlargement for Congenital Aortic Valve Stenosis / 日本心臓血管外科学会雑誌

<b>Objective</b> : To investigate the efficacy of aortic valve replacement with annular enlargement for congenital aortic valve stenosis. <b>Methods</b> : Eleven patients underwent aortic valve replacement with annular enlargement for congenital aortic valve stenosis in our institute between January 2002 and July 2012. The clinical status of these patients, including preoperative and postoperative echocardiography, was evaluated in this study. <b>Results</b> : The median age of the patients was 15.5 years (range : 9-38 years). The patients had a mean body surface area of 1.48±0.3 m² (range : 1.00-1.92 m²). Mechanical prostheses were used in all patients and the techniques of aortic annular enlargement were the Nick procedure in 4 patients, Manouguian procedure in 3 (modified Manouguian in 2), Yamaguchi procedure in 2, and Konno procedure in 2. The average follow-up period was 32.1 months (range : 1-117 months). There was neither operative death nor late death. The peak/mean pressure gradient of aortic valve improved from 77.9±31.7/46.6±18.0 mmHg preoperatively to 27.9±7.7/14.8±4.7 mmHg postoperatively and to 28.3±11.1/14.1±7.0 mmHg at intermediate-term follow-up. The estimated left ventricular mass also improved from 206.8±93.4 g preoperatively to 179.7±61.1 g postoperatively and to 100.4±76.3 g at intermediate-term follow-up, respectively. <b>Conclusions</b> : Our series shows the efficacy and safety of aortic valve replacement with annular enlargement for congenital aortic valve stenosis.