Application of real-time 3D-transesophageal echocardiography in aorta valve replacement with bovine pericardium / 中国医学影像技术

ABSTRACT

Objective: To observe the application value of real-time 3D-transesophageal echocardiography (RT-3D-TEE) in aortic valve replacement with bovine pericardium. Methods: Totally 66 patients underwent aortic valve replacement with bovine pericardium were enrolled. Parameters and abnormalities of aortic valve were measured before cardiopulmonary and during intraoperation by using real-time 2D-transesophageal echocardiography (RT-2D-TEE) and RT-3D-TEE,and the examination outcomes were compared with the results of surgical operation. The correlations of transesophageal echocardiography and intraoperative measurements of aortic valve parameters were observed, and the degrees of leaflet damage were assessed. The aortic related parameters and valve function were observed using RT-3D-TEE 1 and 6 months later. Results: The coincidence rate of initial diagnosis of RT-2D-TEE and RT-3D-TEE with intraoparetive diagnosis was all 100%. The secondary diagnosis of RT-2D-TEE was inconsistent with intraoparetive diagnosis in 5 cases (coincidence rate 92.42%, 61/66), also of RT-3D-TEE (coincidence rate 96.97%, 64/66) in 2 cases among them. Comparing RT-2D-TEE and RT-3D-TEE in the diagnosis of number of leaflets, leaflet perforation, leaflet vegetation and rheumatic aortic valve damage) in all 66 cases, the coincidence rate of RT-3D-TEE was higher than that of RT-2D-TEE. The diameter of aortic annular, aortic sinus and aortic sinus tube, effective height (eH) measured with RT-2D-TEE were lower than those with RT-3D-TEE and intraoperative measurement (both P0.05). RT-3D-TEE measured values were closer to intraoperative measurement compared with RT-2D-TEE. Six months after aortic valve replacement, less than moderate aortic regurgitation was found in 60 patients (60/66,90.91%). Conclusion: RT-3D-TEE measurement can reflect the actual situation realistically and evaluate the feasibility of surgical operation, therefore being valuable for guiding aortic valve replacement with bovine pericardium.