[Dynamics Evaluation of Remodeling Operation Using 4-dimentional Computed Tomography].

Q4 Medicine Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-07-01
Yuya Kise, Syohei Miyaguni, Masahiro Toyama, Syogo Niizaki, Keita Miyaishi, Syotaro Higa, Mizuki Ando, Tatsuya Maeda, Hitoshi Inafuku, Takaaki Nagano, Kojiro Furukawa
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Abstract

Objectives: The extensibility of the aortic root after the remodeling procedure was evaluated using 4-dimentional computed tomography( 4D-CT).

Patients and methods: Seventeen patients( 13 males/4 females), mean age 52 years, who had undergone the remodeling procedure in the last 3 years were included. To understand the dynamics of the aortic root after reconstruction, the R-R interval on the electrocardiogram was divided into 10 equal parts, and the percentage change in area of the basal ring/Valsalva sinus/sino-tubular junction (STJ) level was calculated to evaluate the extensibility of the aortic root. For the basal ring, changes in ellipticity and circumference were also compared.

Results: Basal ring, Valsalva sinus, and STJ area changes with cardiac cycle were similar to those in the control group. Basal ring showed a regular circle in systole and an oval in diastole, and its circumference was enlarged in systole.

Conclusions: The use of 4D-CT made it possible to evaluate the extensibility of the aortic root after remodeling procedure. In particular, the mobility of the basal ring is large, suggesting that it guarantees the physiological opening and closing of the valve and contributes to its durability.

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[利用四维计算机断层扫描对重塑手术进行动态评估]。
目的:使用四维计算机断层扫描(4D-CT)评估重塑术后主动脉根部的伸展性:使用四维计算机断层扫描(4D-CT)评估重塑术后主动脉根部的伸展性:患者和方法:17 名患者(13 男/4 女),平均年龄 52 岁,在过去 3 年中接受过重塑手术。为了解重塑后主动脉根部的动态变化,将心电图上的 R-R 间期分为 10 等份,并计算基底环/Valsalva 窦/中管交界处(STJ)水平面积变化的百分比,以评估主动脉根部的伸展性。同时还比较了基底环的椭圆度和周长的变化:结果:基底环、瓦尔萨尔瓦窦和 STJ 面积随心动周期的变化与对照组相似。基底环在收缩期呈规则圆形,舒张期呈椭圆形,周径在收缩期增大:结论:使用 4D-CT 可以评估重塑术后主动脉根部的伸展性。结论:使用 4D-CT 可以评估重塑术后主动脉根部的伸展性,尤其是基底环的活动度较大,表明它可以保证瓣膜的生理性开放和关闭,并有助于瓣膜的耐久性。
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