Preoperative Assessment Of Aortic Root In The Transcatheter Aortic Valve Replacement By Real-time 3-dimensional Transesophageal Echocardiography And Multidetector Spiral Computed Tomography

Objective: To evaluate the value of RT 3D-TEE in the preoperative assessment of aortic root morphological structure of patients undergoing transcatheter aortic root replacement,by comparing with the result of multidetector spiral computed tomography.Methods: 20 patients who underwent TAVR in our hospital from December 2017 to December 2020 were enrolled and recorded their general information.The preoperative morphological assessment of aortic root was performed by RT 3D-TEE and MDCT respectively for statistical analysis:1.RT 3D-TEE parameters: left ventricle outflow tract diameter(average diameter(LVOTD-avg),perimeter derived Left ventricle outflow tract diameter(LVOTDPde),area derived left ventricle outflow tract diameter(LVOTD-Ade)),left ventricle outflow tract perimeter(LVOTP),left ventricle outflow tract area(LVOTA),aortic annulus diameter((average diameter(AAD-avg),perimeter derived Aortic annulus diameter(AADPde),area derived aortic annulus diameter(AAD-Ade)),aortic annulus perimeter(AAP),aortic annulus area(AAA)coronary sinus diameter(LCSD,RCSD,NCSD),average sinotubular junction diameter(STJD-avg),left coronary artery height(LCAH),right coronary artery height(RCAH).2.MDCT parameters: left ventricle outflow tract diameter(average diameter(LVOTDavg),perimeter derived Left ventricle outflow tract diameter(LVOTD-Pde),area derived left ventricle outflow tract diameter(LVOTD-Ade)),left ventricle outflow tract perimeter(LVOTP),left ventricle outflow tract area(LVOTA),aortic annulus diameter((average diameter(AAD-avg),perimeter derived Aortic annulus diameter(AADPde),area derived aortic annulus diameter(AAD-Ade)),aortic annulus perimeter(AAP),aortic annulus area(AAA),coronary sinus diameter(LCSD,RCSD,NCSD),average sinotubular junction diameter(STJD-avg),left coronary artery height(LCAH),right coronary artery height(RCAH).Results:1.Comparison between RT 3D-TEE parameters and MDCT parametersLVOTD-avg,LVOTP,LVOTD-Pde,LVOTA,LVOTD-Ade,AAD-avg,AAP,AADPde,AAA,AAD-Ade,LCSD,RCSD,NCSD,STJD-avg,correction: there was no differences between RT 3D-TEE parameters and MDCT parameters(P>0.05),LCAH,RCAH decreased(P <0.05).2.Correlation analysisThe RT 3D-TEE parameter of LVOTD-avg,LVOTP,LVOTD-Pde,LVOTA,LVOTDAde,AAD-avg,AAP,AAD-Pde,AAA,AAD-Ade,LCSD,NCSD,RCSD,STJD-avg was positively related to the MDCT parameters,LCAH,RCAH was no related to the MDCT parameters.Conclusion: RT 3D-TEE can accurately perform preoperative assessment in structures such as the left ventricular outflow tract,aortic valve annulus,coronary sinus,and sinotublar junction;there are still deficiencies in the assessment of height of the coronary artery,need for supplement of other imaging methods.