<div><h3>Objectives</h3><div>To evaluate the role of 4-dimensional (4D; 3-dimensional [3D] + time) analysis using multiphase cardiac computed tomography (MCCT) in the description of the aortic annulus (AA) of bicuspid aortic valves (BAV) with regard to the latest expert consensus classification.</div></div><div><h3>Methods</h3><div>Electrocardiography-gated MCCT of 15 patients with BAV were analyzed using in-house software and compared to 15 patients with normal tricuspid aortic valve (TAV). The AA border was pinpointed on 9 reconstructed planes, and the 3D coordinates of the 18 consecutive points were interpolated in 3D using a cubic spline to calculate 3D areas, perimeters, diameters, eccentricity indexes, and global height. Measurements were repeated throughout the cardiac cycle (10 phases). Three additional planes were generated at the level of the left ventricular outflow tract (LVOT), the sinus of Valsalva, and the sinotubular junction.</div></div><div><h3>Results</h3><div>The annulus area was significantly larger in BAV compared to TAV (mean indexed 3D area, 5.64 ± 0.84 cm<sup>2</sup>/m<sup>2</sup> vs 4.3 ± 0.38 cm<sup>2</sup>/m<sup>2</sup>, respectively; <em>P</em> < .001). The AA was also larger in BAV in terms of perimeter, diameters, and height (<em>P</em> < .001). The Valsalva sinuses and sinotubular junction also were significantly larger in BAV compared to TAV (mean area in end-diastole, 6.06 ± 1.00 cm<sup>2</sup> vs 4.69 ± 1.00 cm<sup>2</sup> [<em>P</em> < .001] and 5.13 ± 1.62 cm<sup>2</sup> vs 3.62 ± 0.99 cm<sup>2</sup> [<em>P</em> < .001], respectively). In BAV, 3D AA shape analysis helps distinguish the 3 types of BAV: the 2-sinus type (symmetrical), the fused type, and the partial-fusion type or “form fruste” (both asymmetrical). It also allows determination of the position and height of the nonfunctional commissure. In symmetrical BAV, the nonfunctional commissure was significantly lower than the other commissures (6.01 ± 4.27 mm vs 18.24 ± 3.20 mm vs 17.15 ± 3.60 mm; <em>P</em> < .001), whereas in asymmetrical BAV, the 3 commissures were of comparable height (16.38 ± 0.86 mm vs 15.88 ± 1.69 mm vs 15.37 ± 0.88 mm; <em>P</em> = .316). There was no difference in AA eccentricity indices between TAV and BAV in all phases of the cardiac cycle; however, there was a spectrum of ellipticity for the other components of the aortic root among the different types of valves: going from TAV to asymmetrical BAV to symmetrical BAV, at end-diastole, the LVOT became more circular and the sinuses of Valsalva became more elliptical.</div></div><div><h3>Conclusions</h3><div>3D morphometric analysis of the BAV using MCCT allows identification of the type of BAV and the position and height of the nonfunctional commissure. There are significant differences in the morphology of the aortic root between TAV and the different types of BAV. Further studies are needed to evaluate the impact of 3D analysis on the procedural planning for path
方法使用内部软件分析 15 例 BAV 患者的心电图门控 MCCT，并与 15 例正常三尖瓣主动脉瓣（TAV）患者进行比较。在 9 个重建平面上精确定位 AA 边界，并使用三次样条曲线对 18 个连续点的三维坐标进行三维插值，以计算三维面积、周长、直径、偏心指数和整体高度。在整个心动周期（10 个阶段）内重复测量。结果与 TAV 相比，BAV 的瓣环面积明显更大（平均指数化三维面积分别为 5.64 ± 0.84 cm2/m2 vs 4.3 ± 0.38 cm2/m2; P <.001）。就周长、直径和高度而言，BAV 的 AA 也更大（P < .001）。与 TAV 相比，BAV 的 Valsalva 窦和窦管交界处也明显更大（舒张末期的平均面积分别为 6.06 ± 1.00 cm2 vs 4.69 ± 1.00 cm2 [P < .001] 和 5.13 ± 1.62 cm2 vs 3.62 ± 0.99 cm2 [P < .001]）。在 BAV 中，三维 AA 形状分析有助于区分 3 种类型的 BAV：2-窦型（对称）、融合型和部分融合型或 "畸形"（均不对称）。此外，还能确定无功能委曲的位置和高度。在对称型 BAV 中，非功能性会厌明显低于其他会厌（6.01 ± 4.27 mm vs 18.24 ± 3.20 mm vs 17.15 ± 3.60 mm；P < .001），而在不对称型 BAV 中，3 个会厌的高度相当（16.38 ± 0.86 mm vs 15.88 ± 1.69 mm vs 15.37 ± 0.88 mm；P = .316）。在心动周期的所有阶段，TAV 和 BAV 的 AA 偏心指数均无差异；但是，不同类型瓣膜的主动脉根部的其他组成部分的椭圆度存在差异：从 TAV 到非对称 BAV 再到对称 BAV，在舒张末期，左心室出口变得更圆，而 Valsalva 窦变得更椭圆。结论使用 MCCT 对 BAV 进行形态计量分析，可确定 BAV 的类型以及无功能合谷的位置和高度。TAV 和不同类型的 BAV 在主动脉根部形态上存在明显差异。需要进一步研究评估三维分析对病理性 BAV 手术规划的影响。
{"title":"Four-dimensional computed tomography analysis of bicuspid aortic valves","authors":"Amine Fikani MD , Damian Craiem PhD , Cyrille Boulogne PhD , Gilles Soulat PhD , Elie Mousseaux PhD , Jerome Jouan PhD","doi":"10.1016/j.xjtc.2024.06.012","DOIUrl":"10.1016/j.xjtc.2024.06.012","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the role of 4-dimensional (4D; 3-dimensional [3D] + time) analysis using multiphase cardiac computed tomography (MCCT) in the description of the aortic annulus (AA) of bicuspid aortic valves (BAV) with regard to the latest expert consensus classification.</div></div><div><h3>Methods</h3><div>Electrocardiography-gated MCCT of 15 patients with BAV were analyzed using in-house software and compared to 15 patients with normal tricuspid aortic valve (TAV). The AA border was pinpointed on 9 reconstructed planes, and the 3D coordinates of the 18 consecutive points were interpolated in 3D using a cubic spline to calculate 3D areas, perimeters, diameters, eccentricity indexes, and global height. Measurements were repeated throughout the cardiac cycle (10 phases). Three additional planes were generated at the level of the left ventricular outflow tract (LVOT), the sinus of Valsalva, and the sinotubular junction.</div></div><div><h3>Results</h3><div>The annulus area was significantly larger in BAV compared to TAV (mean indexed 3D area, 5.64 ± 0.84 cm<sup>2</sup>/m<sup>2</sup> vs 4.3 ± 0.38 cm<sup>2</sup>/m<sup>2</sup>, respectively; <em>P</em> < .001). The AA was also larger in BAV in terms of perimeter, diameters, and height (<em>P</em> < .001). The Valsalva sinuses and sinotubular junction also were significantly larger in BAV compared to TAV (mean area in end-diastole, 6.06 ± 1.00 cm<sup>2</sup> vs 4.69 ± 1.00 cm<sup>2</sup> [<em>P</em> < .001] and 5.13 ± 1.62 cm<sup>2</sup> vs 3.62 ± 0.99 cm<sup>2</sup> [<em>P</em> < .001], respectively). In BAV, 3D AA shape analysis helps distinguish the 3 types of BAV: the 2-sinus type (symmetrical), the fused type, and the partial-fusion type or “form fruste” (both asymmetrical). It also allows determination of the position and height of the nonfunctional commissure. In symmetrical BAV, the nonfunctional commissure was significantly lower than the other commissures (6.01 ± 4.27 mm vs 18.24 ± 3.20 mm vs 17.15 ± 3.60 mm; <em>P</em> < .001), whereas in asymmetrical BAV, the 3 commissures were of comparable height (16.38 ± 0.86 mm vs 15.88 ± 1.69 mm vs 15.37 ± 0.88 mm; <em>P</em> = .316). There was no difference in AA eccentricity indices between TAV and BAV in all phases of the cardiac cycle; however, there was a spectrum of ellipticity for the other components of the aortic root among the different types of valves: going from TAV to asymmetrical BAV to symmetrical BAV, at end-diastole, the LVOT became more circular and the sinuses of Valsalva became more elliptical.</div></div><div><h3>Conclusions</h3><div>3D morphometric analysis of the BAV using MCCT allows identification of the type of BAV and the position and height of the nonfunctional commissure. There are significant differences in the morphology of the aortic root between TAV and the different types of BAV. Further studies are needed to evaluate the impact of 3D analysis on the procedural planning for path","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"27 ","pages":"Pages 60-67"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Transesophageal echocardiography, computed tomography, or both when assessing the efficacy of different left atrial appendage closure techniques?","authors":"Oumar Abdel Mahamoud MD, Shaohang Xu MD, Yongjun Qian MD, PhD","doi":"10.1016/j.xjtc.2024.07.004","DOIUrl":"10.1016/j.xjtc.2024.07.004","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"27 ","pages":"Pages 112-113"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.xjtc.2024.07.015
Mohammad Alomari MD , Pankaj Garg MBBS , Nafiye Busra Celik MD , J. Ross Renew MD , Basar Sareyyupoglu MD
{"title":"Heart transplant for a patient with left superior vena cava: Case report and surgical technique","authors":"Mohammad Alomari MD , Pankaj Garg MBBS , Nafiye Busra Celik MD , J. Ross Renew MD , Basar Sareyyupoglu MD","doi":"10.1016/j.xjtc.2024.07.015","DOIUrl":"10.1016/j.xjtc.2024.07.015","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"27 ","pages":"Pages 132-134"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142525847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：