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首页> 外文期刊>Acta Radiologica >Value of cardiac CT in comprehensive aortic valve and root evaluation before percutaneous aortic valve replacement
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Value of cardiac CT in comprehensive aortic valve and root evaluation before percutaneous aortic valve replacement

机译：经皮主动脉瓣置换术前心脏CT在综合主动脉瓣和根评估中的价值

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Background: Aortic stenosis (AS) is the most frequent valvular heart disease, and patients who develop AS are at a high risk of sudden death. There is no medical cure available, and aortic valve replacement is the only effective treatment for advanced disease. Preoperative evaluation is the cornerstone of therapy and is necessary for selecting the implantation technique and valve. Purpose: To evaluate the role of cardiac CT in comprehensive aortic valve and aortic root evaluation before percutaneous aortic valve replacement. Material and Methods: Thirty-four patients with severe aortic valve stenosis were evaluated by cardiac CT. The aortic valve calcification grade defined by cardiac CT was compared to the operative findings. The mean calculated aortic annulus diameter (CAAD) measured by cardiac CT was compared to the aortic annulus diameter measured by transthoracic echocardiography (TTE) as well as during the operation. The distances from the aortic valve annulus to the coronary ostia (right and left) were measured by cardiac CT and compared to the intraoperative measurements. The findings from the CT coronary angiography and conventional coronary angiography were compared. Results: There was strong agreement (k = 0.865) between the calcification grade by cardiac CT and the intraoperative grading. There was a stronger correlation (r = 0.948) between the CAAD assessed by cardiac CT and intraoperatively compared to the correlation between the intraoperative versus TTE measurements (r = 0.660). The distances measured between the aortic annulus and the right and left coronary artery ostia by cardiac CT were strongly correlated with the distances measured intraoperatively (r = 0.966 and 0.940 in the right and left sides, respectively). Cardiac CT detected three coronary artery stenotic lesions and three patent stents. All findings were confirmed by conventional coronary angiography. Thirteen percent of the evaluated coronary artery segments were of non-diagnostic quality by cardiac CT. Conclusion: Cardiac CT substantially facilitates the assessment of aortic root morphology prior to aortic valve replacement.
机译：背景：主动脉瓣狭窄（AS）是最常见的瓣膜性心脏病，而发展为AS的患者极有可能突然死亡。没有可用的药物治疗，主动脉瓣置换术是晚期疾病的唯一有效治疗方法。术前评估是治疗的基石，是选择植入技术和瓣膜的必要条件。目的：评价心脏CT在经皮主动脉瓣置换之前在综合主动脉瓣和主动脉根评估中的作用。材料与方法：对34例重度主动脉瓣狭窄的患者进行了心脏CT检查。将心脏CT定义的主动脉瓣钙化等级与手术结果进行比较。将经心脏CT测量的平均主动脉瓣环直径（CAAD）与经胸超声心动图（TTE）以及手术期间测得的主动脉瓣环直径进行比较。通过心脏CT测量从主动脉瓣环到冠状动脉口的距离（右和左），并将其与术中测量值进行比较。比较了CT冠状动脉造影和常规冠状动脉造影的结果。结果：心脏CT钙化分级与术中分级之间有很强的一致性（k = 0.865）。与术中与TTE测量之间的相关性（r = 0.660）相比，心脏CT评估的CAAD与术中之间的相关性更强（r = 0.948）。通过心脏CT测量的主动脉瓣环与左右冠状动脉口之间的距离与术中测量的距离密切相关（左右两侧分别为r = 0.966和0.940）。心脏CT检测到三个冠状动脉狭窄病变和三个专利支架。所有发现均通过常规冠状动脉造影证实。通过心脏CT，评估的冠状动脉节段中有13％的诊断质量不佳。结论：心脏CT极大地促进了主动脉瓣置换之前主动脉根部形态的评估。

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