Circ: Cardiovasc Inte:二叶主动脉瓣解剖学及其与装置的关联

2019-01-20 xiangting MedSci原创

在BAV中经常观察到瓣膜扩张不足。BAV中基于瓣环的尺寸是准确的,无尺寸过大。

二叶主动脉瓣(BAV)进行经导管主动脉瓣植入的尺寸仍存在争议。

BAVARD回顾性登记(二叶主动脉瓣解剖学及其与装置的关联)目的是获取用于BAV经导管主动脉瓣植入的尺寸比率并分析二代生物瓣膜植入后的几何形态。将经导管主动脉瓣植入术前和术后有多排螺旋CT扫描的101名BAV患者与88名三叶主动脉瓣(TAV)患者进行比较。术前分别有12.9%和86.1%的BAV患者经多排螺旋CT诊断为0型和1型BAV。 在基线时,BAV和TAV患者的椭圆度指数相似:1.2±0.1 vs 1.2±0.1,P=0.09。TAV和BAV患者平均瓣环尺寸过大分别为1.14±0.04和1.04±0.04,P<0.001。平均生物瓣膜内连合距离比例为1.03±0.1。TAV的瓣环生物瓣平均直径与基线时主动脉瓣环的平均周长直径相匹配(23.3±2.2 vs 23.6±1.9,P=0.4),而BAV平均周长直径较小(24±2.8 vs 26.8±3.1,P<0.01),证实BAV中11%的生物瓣膜扩张不足。最后,两组在原位,生物瓣膜直径和椭圆度的模式相同,从远端到12mm以上的数值稳定。

二代生物瓣膜在TAV和BAV中类似地重塑了主动脉环。TAV和BAV中生物瓣膜从远端到12mm的直径一致。 在BAV中经常观察到瓣膜扩张不足。BAV中基于瓣环的尺寸是准确的,无尺寸过大。瓣环上4mm处的内连合距离可以集成在灰色区域中。

原始出处:

Didier Tchetche. Bicuspid Aortic Valve Anatomy and Relationship With Devices: The BAVARD Multicenter Registry  A European Picture of Contemporary Multidetector Computed Tomography Sizing for Bicuspid Valves. Circ: Cardiovascular Interventions. 10 January 2019.

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