Three-dimensional transesophageal echocardiography evaluation of changes in parameters of mitral value pre- and post-left atrial appendage closure
10.3760/cma.j.cn131148-20210316-00169
- VernacularTitle:经食管三维超声心动图评价左心耳封堵术前后二尖瓣结构的参数变化
- Author:
Yashu XIE
1
;
Dehong KONG
;
Yingying JIANG
;
Haiyan CHEN
;
Xiaochun ZHANG
;
Daxin ZHOU
;
Xianhong SHU
;
Cuizhen PAN
Author Information
1. 上海市影像医学研究所 200032
- Keywords:
Echocardiography, transesophageal;
Left atrial appendage closure;
Watchman occluder;
Mitral valve
- From:
Chinese Journal of Ultrasonography
2021;30(9):758-763
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between Watchman occluder and structure of mitral valve apparatus in patients with nonvalvular atrial fibrillation after left atrial appendage closure(LAAC) by transesophageal echocardiography.Methods:From January 2018 to December 2020, 29 patients [20 male, 9 female, (69.55±10.06)years old] with nonvalvular atrial fibrillation underwent LAAC in Zhongshan Hospital (implanted Watchman occluder), and all patients underwent pre-operative and follow-up two and three dimensional transesophageal echocardiography(2DTEE, 3DTEE) at 60 days after the operation. The quantitative parameters of mitral valve apparatus were obtained by offline analysis using the MVA module in QLab 13.0 (Philips Healthcare, Andover, MA), the differences between pre-operation and post-operation were compared, and the relationship between occluder compression ratio and mitral valve parameters with significant changes after operation was analyzed.Results:①The values of AL-PM diameter(AL-PM), 3D annulus circumference(3DAC), 2D annulus area(2DAA), 3D annulus area(3DAA), tenting volume(TnV), tenting area(TnA) and commissural diameter(CD) decreased significantly compared with pre-operative values(all P<0.05), while the annulus sphericity index(SPI) increased significantly ( P<0.05). ②In the quantitative mitral value parameters with significant pre- and post-operation changes, TnV was correlated with the occluder compression ratio ( r=0.403, P=0.030), but AL-PM, SPI, 3DAC, 2DAA, 3DAA, TnA, CD were not correlated with it(all P>0.05). Conclusions:3DTEE can accurately evaluate the effect of Watchman occluder on the morphology of mitral valve device. Implanting Watchman occluder in left atrial appendage can make three-dimensional mitral valve apparatus flat and decrease annulus left-right diameter and annulus area; the pre-operative TnV, the more susceptible to the occluder implantation, and TnV is correlated with the compression ratio.
