Aortic root morphology in patients undergoing percutaneous aortic valve replacement: Evidence of aortic root remodeling
Aortic root morphology in patients undergoing percutaneous aortic valve replacement: Evidence of aortic root remodeling
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DOI：
10.1016/j.jtcvs.2008.07.062
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发表时间：
2009-04-01
影响因子：
6
通讯作者：
Sola, Srikanth
中科院分区：
文献类型：
--
作者：
Akhtar, Mateen;Tuzcu, E. Murat;Sola, Srikanth
目的：经皮主动脉瓣置换术是一种治疗严重主动脉瓣狭窄的新方法。主动脉根部的术前成像有助于经皮主动脉瓣置换术装置的大小和部署。我们使用多探测器计算机断层扫描比较了主动脉狭窄患者与性别匹配的老年人的主动脉根部形态学特征。方法：连续25例经皮主动脉瓣置换术的严重钙化性主动脉瓣狭窄患者和25例性别匹配的老年对照者在西门子定义双源（Siemens Medical, Forchheim, Germany）多探测器计算机断层扫描仪上进行扫描。测定了瓣环到冠状动脉口和窦管交界处的距离、主动脉根的尺寸和瓣尖的特征。结果：与对照组相比，主动脉瓣狭窄患者主动脉瓣环到左右冠状动脉口下缘及窦小管交界处的距离缩短。主动脉根部的横截面尺寸无明显差异。结论：与对照组相比，主动脉瓣狭窄患者主动脉瓣环到冠状动脉开口和窦小管交界处的距离缩短。这一发现表明主动脉根部纵向重塑发生在钙化性主动脉狭窄中，这对经皮主动脉瓣置换术的设计和部署具有重要意义。
Objective: Percutaneous aortic valve replacement is an emerging therapy for selected patients with severe aortic stenosis. Preoperative imaging of the aortic root facilitates sizing and deployment of the percutaneous aortic valve replacement device. We compared morphologic characteristics of the aortic root in patients with aortic stenosis versus elderly gender-matched controls using multidetector computed tomography.Methods: Twenty-five consecutive subjects with severe calcific aortic stenosis referred for percutaneous aortic valve replacement and 25 elderly gender-matched controls were scanned on a Siemens Definition Dual Source (Siemens Medical, Forchheim, Germany) multidetector computed tomography scanner. Distances from the valve annulus to the coronary artery ostia and sinotubular junction, dimensions of the aortic root, and characteristics of the valve cusps were determined.Results: Subjects with aortic stenosis had reduced distance from the aortic valve annulus to the inferior margins of the left and right coronary artery ostium and sinotubular junction compared with controls. There were no significant differences in cross-sectional dimensions of the aortic root.Conclusion: The distance from the aortic valve annulus to the coronary artery ostia and sinotubular junction is reduced in patients with aortic stenosis compared with controls. This finding suggests that longitudinal remodeling of the aortic root occurs in calcific aortic stenosis and has implications for the design and deployment of percutaneous aortic valve replacement devices.