Feasibility of in vivo human aortic valve modeling using real-time three-dimensional echocardiography.
Publication/Presentation Date
4-1-2014
Abstract
BACKGROUND: Surgical techniques for aortic valve (AV) repair are directed toward restoring normal structural relationships in the aortic root and rely on detailed assessment of root and valve anatomy. Noninvasive three-dimensional (3D) imaging and modeling may assist in patient selection and operative planning.
METHODS: Transesophageal real-time 3D echocardiographic images of 5 patients with normal AVs were acquired. The aortic root and the annulus were manually segmented at end diastole using a 36-point rotational template. The AV leaflets and the coaptation zone were manually segmented in parallel 1-mm cross sections. Quantitative 3D models of the AV and root were generated and used to measure standard anatomic parameters and were compared to conventional two-dimensional echocardiographic measurements. All measurements are given as mean±SD.
RESULTS: Annular, sinus, and sinotubular junction areas were 4.1±0.6 cm2, 7.5±1.2 cm2, and 3.9±1.0 cm2, respectively. Root diameters (measured in three locations) by 3D model inspection and two-dimensional echocardiography measurement correlated (R2=0.75). Noncoapted areas of the left, right, and noncoronary leaflets were 1.9±0.2 cm2, 1.6±0.3 cm2, and 1.6±0.3 cm2, respectively. Mean coaptation areas for the left-right, left-noncoronary, and right-noncoronary coaptation zones were 87.7±36.9 mm2, 69.9±20.7 mm2, and 114.2±23.0 mm2, respectively. The mean ratio of noncoapted leaflet area to annular area was 1.3±0.2.
CONCLUSIONS: High-resolution 3D models of the in vivo normal human aortic root and valve were generated using 3D echocardiography. Quantitative 3D models and analysis may assist in characterization of pathology and decision making for AV repair.
Volume
97
Issue
4
First Page
1255
Last Page
1258
ISSN
1552-6259
Published In/Presented At
Jassar, A. S., Levack, M. M., Solorzano, R. D., Pouch, A. M., Ferrari, G., Cheung, A. T., Ferrari, V. A., Gorman, J. H., 3rd, Gorman, R. C., & Jackson, B. M. (2014). Feasibility of in vivo human aortic valve modeling using real-time three-dimensional echocardiography. The Annals of thoracic surgery, 97(4), 1255–1258. https://doi.org/10.1016/j.athoracsur.2013.12.017
Disciplines
Medicine and Health Sciences
PubMedID
24518577
Department(s)
Department of Medicine, Cardiology Division
Document Type
Article