Three‐dimensional transesophageal echocardiography of aortic‐mitral valve coupling changes in patients with severe aortic stenosis after surgical aortic valve replacement and transcatheter aortic valve implantation
10.3760/cma.j.issn.1004‐4477.2019.07.004
- VernacularTitle:三维经食管超声心动图评估重度主动脉瓣狭窄患者经胸主动脉瓣置换术与经导管主动脉瓣置入术后主动脉瓣 －二尖瓣联合体变化
- Author:
Lei ZHANG
1
;
Hsiung MINGCHON
;
Hongfeng WANG
;
Shaohui QU
;
Jiawei TIAN
Author Information
1. 哈尔滨医科大学附属第二医院超声科150081
- Keywords:
Echocardiography,transesophageal,three-dimensional;
Aortic valve stenosis;
Aortic‐mitral valve coupling;
Surgicar aortic valve replacement;
T ranscatheter aortic valve implantation
- From:
Chinese Journal of Ultrasonography
2019;28(7):595-600
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the morphologic and functional changes of the aortic‐mitral valve coupling ( AMC) after surgical aortic valve replacement ( SAVR) or transcatheter aortic valve implantation ( T AVI ) in patients with severe aortic stenosis ( AS) using three‐dimensional transesophageal echocardiography ( 3D‐T EE) . Methods Ninty‐three severe AS patients were chosed as AS group in which 43 cases underwent SAVR and 50 cases underwent T AVI . T EE was performed before and after operation . T hirty‐one age‐and gender‐matched patients who underwent 3D‐T EE for exclusion of intracardiac thrombus were selected as control group . Cardiovascular quantitative analysis software was used to measure the parameters of aortic valve ,mitral valve and AMC in the the control group ,the SAVR group and the T AVI group before and after operation . Results ① Compared with control group ,the antero posterior ( AP ) diameter of mitral value in AS group increased ,the ellipticity of mitral valve decreased ,the height of the mitral annulus increased ( all P＜ 0 .05 ) . T he open area of aortic valve decreased ,the aortic regurgitation area ,aortic regurgitant flow velocity and the diameter of the aortic annulus increased( all P ＜0 .05) . T here was no statistical difference in aortic‐mitral valvular angle ( AM A ) and other parameters( all P ＞0 .05) . ②After SAVR ,the anterolateral‐posteromedial diameter ,AP diameter ,perimeter and area of mitral valve decreased ,the ellipticity of mitral valve increased( all P ＜0 .05) . T he aortic valve opening area increased ,the aortic regurgitation area and aortic regurgitant flow velocity decreased ( all P ＜ 0 .05 ) . T here was no statistical difference in AM A and other parameters( all P ＞0 .05) . ③After TAVI ,the AP diameter ,height , perimeter and area of mitral valve decreased ,the ellipticity of mitral valve increased ( all P ＜ 0 .05 ) . The aortic valve opening area increased ,the aortic regurgitation area ,aortic regurgitant flow velocity and the diameter of the aortic annulus decreased ( all P ＜ 0 .05 ) . T here was no statistical difference in AM A and other parameters( all P ＞0 .05) . Conclusions After SAVR and T AVI ,the anatomy and function of AMC in patients with severe AS changed to varying degrees after operation . It demonstrates that the impacts of both AS and repairment of AS on the mitral valve were . In addition ,after SAVR and T AVI ,the geometry and function of aortic and mitral valves of the patients recovered to some degrees .
