1.Methodology study for the anatomic structure of aortic root using three-dimensional transesophageal echocardiography
Junli WANG ; Hua DING ; Mingchon HSIUNG ; Lixue YIN ; Weihsian YIN ; Jeng WEI
Chinese Journal of Ultrasonography 2015;(12):1019-1023
Objective To establish a quantitative analysis method for the anatomic structure of aortic root by real-time three-dimensional transesophageal echocardiography,and to explore the reliability and repeatability of this method.Methods Ninety five adult patients underwent RT-3DTEE were included in this study.Full-volume 3D images of aortic root were acquired and analyzed offline with QLab-3DQ (iE33, Philips).The three mutually perpendicular plane were determined.Results 1 )Aortic root:At the end of diastole,the diameter and area of coronary artery sinus bottoms level was 1 .84 cm and 3.45 cm2 ;the diameter and area of top commissural level was 2.97 cm and 7.77 cm 2 ;the diameter and area of sino-tubular junction level was 2.72 cm and 5.44 cm 2 .2)Aortic sinus:right coronary sinus was widest,left coronary sinus was the most stenosis(P <0.05).The repeatability of each parameters was well (P >0.50).The measurement of each parameter,which analysis among different angles showed that 0° region were more accurate than others.Conclusions 3D quantitative analysis to aortic root can be established by full-volume RT-3DTEE images and has better reliability and repeatability.
2.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
Lei ZHANG ; Hsiung MINGCHON ; Hongfeng WANG ; Shaohui QU ; Jiawei TIAN
Chinese Journal of Ultrasonography 2019;28(7):595-600
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 .