Value of aortic root CTA assessment in aortic valve surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

JIAO Jing ¹ , FANG Liang ² , ZHANG Busheng ² , XIE Xiaoyi ³ , ZHAO Naishi ² , WANG Yinghua ⁴ , WU Weihua ³ ,  KONG Ye ²

1. Department of Radiology, Shanghai Chest Hospital, Shanghai, 200030, P.R.China;
2. Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai, 200030, P.R.China;
3. Department of Ultrasound, Shanghai Chest Hospital, Shanghai, 200030, P.R.China;
4. Department of Intensive Care Unit, Shanghai Chest Hospital, Shanghai, 200030, P.R.China;

Corresponding author：

KONG Ye, Email: kongye2008@outlook.com

Keywords：

Aortic valve repair; aortic valve; aortic root CTA

DOI：

10.7507/1007-4848.202011089

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the data of preoperative aortic root CT angiography (CTA), compare it with two-dimensional transthoracic echocardiography and investigate the correlation of the two measurements with the actual intraoperative measurement data.Methods Clinical data of 53 patients with aortic valve diseases who underwent aortic valve repair in our hospital from January 2018 to August 2020 were retrospectively analyzed, including 38 males and 15 females with an average age of 42.9±18.3 years ranging from 10 to 77 years. Preoperative two-dimensional transthoracic echocardiography (TTE) and aortic root CTA measurements were collected, including aortic valve annulus (AVA), aortic sinus (Sinus) and sino-tubular junction (STJ). In comparison with the intraoperative measurements during the aortic valve repair surgery, the consistency analysis was performed.Results Both the preoperative echocardiography AVA measurements and the CT AVA measurements were positively correlated with the intraoperative AVA measurements (P<0.001). Compared with the echocardiography AVA data [correlation coefficient (ρ)=0.74, mean squarederror (MSE)=12.78], the CT AVA data were more accurate and consistent with the intraoperative AVA measurements (ρ=0.95, MSE=2.72). CT AVA data had a higher correlation coefficient with the intraoperative measurements, compared to that of the echocardiography AVA data (P<0.001).Conclusion In comparison with two-dimensional transthoracic echocardiography, preoperative morphological evaluation of aortic root CTA is more consistent with the actual intraoperative measurements during aortic valve repair surgery.

Citation： JIAO Jing, FANG Liang, ZHANG Busheng, XIE Xiaoyi, ZHAO Naishi, WANG Yinghua, WU Weihua, KONG Ye. Value of aortic root CTA assessment in aortic valve surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(1): 80-84. doi: 10.7507/1007-4848.202011089 Copy

1.	Underwood MJ, El Khoury G, Deronck D, et al. The aortic root: Structure, function, and surgical reconstruction. Heart, 2000, 83(4): 376-380.
2.	Lange R, Badiu CC, Vogt M, et al. Valve-sparing root replacement in children with aortic root aneurysm: Mid-term results. Eur J Cardiothorac Surg, 2013, 43(5): 958-964.
3.	Tweddell JS, Pelech AN, Jaquiss RD, et al. Aortic valve repair. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2005: 112-21.
4.	Maddalo S, Beller J, DeAnda A. A Bentall is not a Bentall is not a Bentall: The evolution of aortic root surgery. Aorta (Stamford), 2014, 2(5): 169-178.
5.	Monsefi N, Zierer A, Risteski P, et al. Long-term results of aortic valve resuspension in patients with aortic valve insufficiency and aortic root aneurysm. Interact Cardiovasc Thorac Surg, 2014, 18(4): 432-437.
6.	Yacoub MH, Cohn LH. Novel approaches to cardiac valve repair: From structure to function: Part Ⅰ. Circulation, 2004, 109(8): 942-950.
7.	De Paulis R, Salica A. Surgical anatomy of the aortic valve and root-implications for valve repair. Ann Cardiothorac Surg, 2019, 8(3): 313-321.
8.	Guo MH, Boodhwani M. Aortic valve repair: From concept to future targets. Semin Thorac Cardiovasc Surg, 2019, 31(4): 650-655.
9.	Hammermeister K, Sethi GK, Henderson WG, et al. Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: Final report of the Veterans Affairs randomized trial. J Am Coll Cardiol, 2000, 36(4): 1152-1158.
10.	Aicher D, Fries R, Rodionycheva S, et al. Aortic valve repair leads to a low incidence of valve-related complications. Eur J Cardiothorac Surg, 2010, 37(1): 127-132.
11.	Bierbach BO, Aicher D, Issa OA, et al. Aortic root and cusp configuration determine aortic valve function. Eur J Cardiothorac Surg, 2010, 38(4): 400-406.
12.	Koshkelashvili N, Jalife Bucay M, Goykhman I, et al. Aortic root and valve proportions: An example of the golden ratio? Monaldi Arch Chest Dis, 2019, 89(2): 161-164.
13.	Hagendorff A, Evangelista A, Fehske W, et al. Improvement in the assessment of aortic valve and aortic aneurysm repair by 3-dimensional echocardiography. JACC Cardiovasc Imaging, 2019, 12(11 Pt 1): 2225-2244.
14.	Chirichilli I, Irace F, Weltert L, et al. Morphological modification of the aortic annulus in tricuspid and bicuspid valves after aortic valve reimplantation: An electrocardiography-gated computed tomography study. Eur J Cardiothorac Surg, 2019, 56(4): 778-784.
15.	Plonek T, Berezowski M, Bochenek M, et al. A comparison of aortic root measurements by echocardiography and computed tomography. J Thorac Cardiovasc Surg, 2019, 157(2): 479-486.
16.	Blanke P, Weir-McCall JR, Achenbach S, et al. Computed tomography imaging in the context of transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR): An expert consensus document of the Society of Cardiovascular Computed Tomography. JACC Cardiovasc Imaging, 2019, 12(1): 1-24.
17.	Rimmer L, Ahmad MU, Chaplin G, et al. Aortic valve repair: Where are we now? Heart Lung Circ, 2019, 28(7): 988-999.

1. Underwood MJ, El Khoury G, Deronck D, et al. The aortic root: Structure, function, and surgical reconstruction. Heart, 2000, 83(4): 376-380.
2. Lange R, Badiu CC, Vogt M, et al. Valve-sparing root replacement in children with aortic root aneurysm: Mid-term results. Eur J Cardiothorac Surg, 2013, 43(5): 958-964.
3. Tweddell JS, Pelech AN, Jaquiss RD, et al. Aortic valve repair. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2005: 112-21.
4. Maddalo S, Beller J, DeAnda A. A Bentall is not a Bentall is not a Bentall: The evolution of aortic root surgery. Aorta (Stamford), 2014, 2(5): 169-178.
5. Monsefi N, Zierer A, Risteski P, et al. Long-term results of aortic valve resuspension in patients with aortic valve insufficiency and aortic root aneurysm. Interact Cardiovasc Thorac Surg, 2014, 18(4): 432-437.
6. Yacoub MH, Cohn LH. Novel approaches to cardiac valve repair: From structure to function: Part Ⅰ. Circulation, 2004, 109(8): 942-950.
7. De Paulis R, Salica A. Surgical anatomy of the aortic valve and root-implications for valve repair. Ann Cardiothorac Surg, 2019, 8(3): 313-321.
8. Guo MH, Boodhwani M. Aortic valve repair: From concept to future targets. Semin Thorac Cardiovasc Surg, 2019, 31(4): 650-655.
9. Hammermeister K, Sethi GK, Henderson WG, et al. Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: Final report of the Veterans Affairs randomized trial. J Am Coll Cardiol, 2000, 36(4): 1152-1158.
10. Aicher D, Fries R, Rodionycheva S, et al. Aortic valve repair leads to a low incidence of valve-related complications. Eur J Cardiothorac Surg, 2010, 37(1): 127-132.
11. Bierbach BO, Aicher D, Issa OA, et al. Aortic root and cusp configuration determine aortic valve function. Eur J Cardiothorac Surg, 2010, 38(4): 400-406.
12. Koshkelashvili N, Jalife Bucay M, Goykhman I, et al. Aortic root and valve proportions: An example of the golden ratio? Monaldi Arch Chest Dis, 2019, 89(2): 161-164.
13. Hagendorff A, Evangelista A, Fehske W, et al. Improvement in the assessment of aortic valve and aortic aneurysm repair by 3-dimensional echocardiography. JACC Cardiovasc Imaging, 2019, 12(11 Pt 1): 2225-2244.
14. Chirichilli I, Irace F, Weltert L, et al. Morphological modification of the aortic annulus in tricuspid and bicuspid valves after aortic valve reimplantation: An electrocardiography-gated computed tomography study. Eur J Cardiothorac Surg, 2019, 56(4): 778-784.
15. Plonek T, Berezowski M, Bochenek M, et al. A comparison of aortic root measurements by echocardiography and computed tomography. J Thorac Cardiovasc Surg, 2019, 157(2): 479-486.
16. Blanke P, Weir-McCall JR, Achenbach S, et al. Computed tomography imaging in the context of transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR): An expert consensus document of the Society of Cardiovascular Computed Tomography. JACC Cardiovasc Imaging, 2019, 12(1): 1-24.
17. Rimmer L, Ahmad MU, Chaplin G, et al. Aortic valve repair: Where are we now? Heart Lung Circ, 2019, 28(7): 988-999.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Value of aortic root CTA assessment in aortic valve surgery

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