Conformational Pulsatile Changes of the Aortic Annulus

摘要: Objectives This study sought to investigate pulsatile changes of the aortic annulus and their impact on prosthesis selection by computed tomography (CT). Background Precise noninvasive sizing is a prerequisite for transcatheter valve replacement. Methods A total 110 patients with severe stenosis (mean age: 82.9 ± 8 years, mean area: 0.69 0.18 cm(2)) underwent electrocardiogram-gated CT. Aortic dimensions were planimetrically quantified as area-derived diameter (D(A) = 2 ×✓(CSA/π), where CSA cross-sectional area) perimeter-derived (D(P) P/π, P length perimeter) in 5% increments RR interval. Hypothetical was based D(A) D(P) (23-mm 25 mm) compared between maximum traditional cardiac CT reconstruction phases at 35% 75% RR. Agreement calculated κ statistics. Results increased eccentricity reduced during systole, D(A-MAX) D(P-MAX) most often observed 20% consistently larger than D(A). Average net differences 2.0 0.6 mm 1.7 0.5 D(A-MIN) versus D(P-MIN) D(P-MAX). found 93 (κ 0.75) D(A-75%) 80 0.53) D(A-35%); 94 0.73) D(P-75%) D(P-35%). With or D(P-75%), nominal smaller 15 6 respectively. Conclusions morphology exhibits conformational throughout cycle due deformation stretch. These affect selection. Prosthesis diastolic perimeter- harbors risk undersizing.