Preoperative Computed Tomography Scan Analysis of Interleaflets Triangles to Guide Aortic Root Repair Procedures.
J Heart Valve Dis
; 26(1): 12-17, 2017 Jan.
Article
em En
| MEDLINE
| ID: mdl-28544826
ABSTRACT
BACKGROUND:
Stabilization of the ventriculo-aortic junction (VAJ) is gaining increasing interest in the context of aortic valve repair, since its dilation is a well-recognized risk factor for long-term repair failure. Interleaflets triangles are key elements of the VAJ, but cannot be completely visualized using echocardiography. A three-dimensional (3D) reconstruction of electrocardiogram-triggered computed tomography (CT) scan images allows an analysis of the real dimensions and anatomic characteristics of the subcommissural triangles.METHODS:
A method was developed to visualize the interleaflets triangle at the CT-scan based on multiplanar post-processing reconstructions. Attention was focused on the triangles' apical angle evaluation. The data obtained with CT-scan reconstructions were compared with those collected in a previous post-mortem study to validate this measurement method.RESULTS:
In the CT-scan group the angles between the left and right coronary sinuses, and the right non-coronary and left non-coronary sinuses were 46.23 ± 7.79°, 47.38 ± 6.97°, 45° [range 42.75- 50.75°], respectively, and in the post-mortem group were 45.44 ± 12.39°, 48.31 ± 1218°, 50.25 ± 7.29°. No statistically significant differences between the two groups were identified (p = 0.84, 0.81, and 0.23).CONCLUSIONS:
Based on experience acquired in the operating room, the acute-angle subcommissural triangles were considered normal, the equilateral triangles mildly dilated, and the obtuse triangles severely dilated. According to this classification, different reparative approaches were selected. A CTscan 3D reconstruction method, as validated by the present data, allows a preoperative evaluation of the triangles and VAJ in order to best plan a surgical reparative approach tailored to a single patient.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Valva Aórtica
/
Insuficiência da Valva Aórtica
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Heart Valve Dis
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article