Your browser doesn't support javascript.
loading
Left ventricular outflow tract shape after aortic valve replacement with St. Jude Trifecta prosthesis.
Barletta, Giuseppe; Venditti, Francesco; Stefano, Pierluigi; Del Bene, Riccarda; Di Mario, Carlo.
Afiliación
  • Barletta G; Cardiology Diagnostics, Cardiac, Thoracic & Vascular Department, University Hospital Careggi, Florence, Italy.
  • Venditti F; Cardiology Diagnostics, Cardiac, Thoracic & Vascular Department, University Hospital Careggi, Florence, Italy.
  • Stefano P; Cardiac Surgery, Cardiac, Thoracic & Vascular Department, University Hospital Careggi, Florence, Italy.
  • Del Bene R; Cardiology Diagnostics, Cardiac, Thoracic & Vascular Department, University Hospital Careggi, Florence, Italy.
  • Di Mario C; Structural Interventional Cardiology Division, Cardiac, Thoracic & Vascular Department, University Hospital Careggi, Florence, Italy.
Echocardiography ; 35(3): 329-336, 2018 03.
Article en En | MEDLINE | ID: mdl-29272555
BACKGROUND: Aortic prosthesis area (EOA) is computed by continuity equation from left ventricular (LV) stroke volume (SV) derived from LV outflow tract diameter (LVOTD ) or, when unmeasurable, from LV volumes (SVV ). There is evidence to suggest LVOT ellipticity and recommend 3D LVOT area (LVOTCSA ) adoption in aortic stenosis. We sought to evaluate if the same concept applies to supra-annular aortic prosthesis comparing SV and EOA derived from LVOTD (EOAD ) and from LVOTCSA (EOACSA ). EOA computed from SVV (EAOV ) accuracy was evaluated in this setting. Patient-prosthesis mismatch (PPM) was compared among different EOA computations. METHODS: A consecutive series of 202 patients (aged 81 ± 4 years, 43% males) underwent St.Jude Trifecta aortic valve replacement (AVR) and were followed up with echocardiography at one-year (335 ± 31 days). All measurements followed the EACVI or ASE guidelines, 3D X-plane modality was used to compute SVv and measure LVOTCSA ; SV was calculated from LVOTD (SVD ) and LVOTCSA (SVCSA ). PPM was indexed EOA <0.65 cm²/m². RESULTS: LVOT showed a significant ellipticity index (1.17 ± .27), independent of prosthesis size. EOAD (1.70 ± 0.55 cm²) was less than EOACSA (1.95 ± 0.62 cm²) (P < .0001). SVV was significantly lower than SVD and SVCSA . Bland-Altman analysis showed a significant correlation between SVV and SVD or SVCSA although with large bias and imprecision. The correlations improved reducing bias and imprecision when LVOT time-velocity integral was <20 cm. PPM incidence was higher in EOAV (15.6%) compared to EOAD (P = .04) or EOACSA (P < .001). CONCLUSIONS: In supra-annular AVR, LVOT retains its elliptical shape and LVOTCSA yielded larger prosthesis EOA with lower PPM incidence. PPM may be overestimated by EOAV .
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prótesis Valvulares Cardíacas / Ecocardiografía / Implantación de Prótesis de Válvulas Cardíacas / Ventrículos Cardíacos Límite: Aged80 / Female / Humans / Male Idioma: En Revista: Echocardiography Asunto de la revista: CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Año: 2018 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prótesis Valvulares Cardíacas / Ecocardiografía / Implantación de Prótesis de Válvulas Cardíacas / Ventrículos Cardíacos Límite: Aged80 / Female / Humans / Male Idioma: En Revista: Echocardiography Asunto de la revista: CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Año: 2018 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos