经食道三维超声心动图在经心尖导管主动脉瓣植入术中主动脉瓣环评估的临床应用研究

Clinical application of transesophageal three-dimensional echocardiography in the evaluation of aortic annulus for transapical transcatheter aortic valve implantation

目的探讨经食道三维超声心动图(3D-TEE)经心尖途径经导管主动脉瓣置入术(TA-TAVI)术前及术中评估的可行性及有效性,并分析与多层螺旋CT(MDCT)测量主动脉瓣环直径之间的相关性。方法回顾性研究2018年1月至11月西京医院TA-TAVI手术患者3D-TEE及MDCT测量数据,共44例,所有患者术前均行全麻下行3D-TEE检查,应用Qlab3DQ软件分析测量主动脉瓣环直径及面积,根据圆形面积公式(S=πr2)求得瓣环直径平均值,并与MDCT测得主动脉瓣环数据进行Pearson相关性检测,比较两种测量方法在评估主动脉瓣瓣环直径的相关性并行统计学分析。结果3D-TEE测得瓣环直径与MDCT测得主动脉瓣瓣环直径数据具有相关性,R=0.944。结论3D-TEE可用于准确测量主动脉瓣环径,从而为TA-TAVI提供可靠的瓣膜型号选择依据,3D-TEE能够更好的对主动脉瓣环直径进行评估。

Objective To investigate the feasibility and effectiveness of preoperative and intraoperative evaluation of transesophageal three-dimensional echocardiography(3 D-TEE)for transapical transcatheter aortic valve implantation(TA-TAVI),and to analyze the correlation between transesophageal three-dimensional echocardiography(3 D-TEE)and multi-slice spiral CT(MDCT)in measuring aortic annular diameter.Methods Data of 3 D-TEE and MDCT of 44 patients undergoing TA-TAVI operation in Xijing Hospital from January to November of 2018 were retrospectively studied.All patients underwent 3 D-TEE examination with general anesthesia before operation.The diameter and area of aortic annulus were analyzed and measured by Qlab 3 DQ software.The average diameter of aortic annulus was calculated according to the formula of circular area(S=πr2).The data of aortic annulus were measured by 3 D-TEE and MDCT respectively.Pearson correlation test was used to compare the correlation between the two methods in evaluating aortic annular diameter.Results The diameter of aortic annulus measured by 3 D-TEE was correlated with that measured by MDCT,R=0.944.Conclusion 3 D-TEE can be used to accurately measure the aortic annular diameter,so as to provide a reliable basis for TA-TAVI valve type selection.3 D-TEE can better evaluate the aortic annular diameter.