Author + information
- Kentaro Shibayama,
- Hiroyuki Watanabe,
- Shunsuke Sasaki,
- Keitaro Mahara,
- Minoru Tabata,
- Toshihiro Fukui,
- jun umemura,
- Shuichiro Takanashi,
- Tetsuya Sumiyoshi and
- Takahiro Shiota
Three-dimensional (3D) anatomical features of the aortic valve apparatus (AVAp) in isolated AR have not been evaluated adequately. This study aimed to clarify structural features of AVAp in different AR types by quantitative analysis using 3D transesophageal echocardiography (TEE).
Methods and Results
Of 182 consecutive patients who underwent surgical correction for isolated AR, 70 patients with single mechanism of AR by surgical inspection and 15 age-, gender- and BSA- matched controls were retrospectively studied. We acquired preoperative 3D TEE datasets including the AVAp, and analyzed the data quantitatively using a novel feature-tracking program. Compared with control, coaptation height (CH) was increased in Type I (9.5±1.6 mm, P<0.001) and decreased in Type II (3.1±1.1 mm, P=0.02). In Type I, aortic root area was dilated, particularly in sinotubular junction (17.6±6.6 cm2, P<0.001). In Type Ill, leaflet lengths were decreased (left-coronary leaflet: 9.1±1.6 mm, P=0.002; non-coronary leaflet: 10.3 ± 1.9 mm; P = 0.01, right-coronary leaflet: 10.9±1.4 mm, P=0.006). With receiver-operating characteristic models, CH by 3D TEE was proven to be the highest discriminatory index for identification of Type I AR among various two-dimensional and 3D TEE parameters. (Figure)
Quantitative analysis of 3D TEE data successfully demonstrates structural features of the AVAp in various AR functional types, and may be a new objective tool for identifying AR mechanisms.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: Echo – Aortic Valve Diseases
Abstract Category: 18. Imaging: Echo
Presentation Number: 1144-364
- 2013 American College of Cardiology Foundation