Aortic prosthetic size predictor in aortic valve replacement
Abstract Background Patient-prosthesis mismatch (PPM) is a major concern in aortic valve replacement (AVR) and leads to perioperative morbidity and rehospitalization. Predicting aortic annulus diameter pre-procedurally is crucial to managing patients with high-risk of PPM. Objectives To compare preo...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-08-01
|
| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-021-01601-z |
| _version_ | 1818885018426015744 |
|---|---|
| author | Anh Tuan Vo Tomomi Nakajima Trang Thi Thu Nguyen Nguyen Thoi Hai Nguyen Nga Bich Le Tri Huu Cao Dinh Hoang Nguyen |
| author_facet | Anh Tuan Vo Tomomi Nakajima Trang Thi Thu Nguyen Nguyen Thoi Hai Nguyen Nga Bich Le Tri Huu Cao Dinh Hoang Nguyen |
| author_sort | Anh Tuan Vo |
| collection | DOAJ |
| description | Abstract Background Patient-prosthesis mismatch (PPM) is a major concern in aortic valve replacement (AVR) and leads to perioperative morbidity and rehospitalization. Predicting aortic annulus diameter pre-procedurally is crucial to managing patients with high-risk of PPM. Objectives To compare preoperative measurements of aortic annulus from echocardiography and CT scan with surgical sizing and develop an imaging-based algorithm to predict PPM. Methods From January 2017 to December 2020, patients underwent AVR at a teaching hospital were examined. The relationship between imaging measurements with operative values was assesed using scatter plots and Pearson’s correlation coefficient. Univariable linear regression was then used to build the predictive model. Results A total of 144 patients underwent AVR during the study period. Suture types and surgical approaches were not significantly associated with prosthesis size. CT scan-based measurements showed strong correlation with prosthesis size: mean diameter (R = 0.79), perimeter-derived diameter (R = 0.76), and area-derived diameter (R = 0.75). Mechanical valve and tissue valve shared similar correlation coefficients. Prosthesis size predictive models based on CT scan were 12.89 + 0.335 × d for mean diameter, 13.275 + 0.315 × d for perimeter-derived diameter and 13.626 + 0.309 × d for area-derived diameter. Conclusions Preoperative CT scan measurements are a reliable predictor of aortic prosthesis size. Transthoracic echocardiography is a possible alternative, though it is highly performer-dependent and unable to represent the aortic annulus fully. Together, these two imaging modalities can be used to quantitatively anticipate PPM preoperatively. |
| first_indexed | 2024-12-19T15:58:46Z |
| format | Article |
| id | doaj.art-944faf71548d4bfbbd54587e81ea89bc |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-19T15:58:46Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-944faf71548d4bfbbd54587e81ea89bc2022-12-21T20:14:59ZengBMCJournal of Cardiothoracic Surgery1749-80902021-08-011611710.1186/s13019-021-01601-zAortic prosthetic size predictor in aortic valve replacementAnh Tuan Vo0Tomomi Nakajima1Trang Thi Thu Nguyen2Nguyen Thoi Hai Nguyen3Nga Bich Le4Tri Huu Cao5Dinh Hoang Nguyen6Department of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Cardiovascular Surgery, Faculty of Medicine, University of TsukubaDepartment of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Thoracic and Cardiovascular Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Thoracic and Cardiovascular Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Surgery, Nguyen Tri Phuong HospitalDepartment of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh CityAbstract Background Patient-prosthesis mismatch (PPM) is a major concern in aortic valve replacement (AVR) and leads to perioperative morbidity and rehospitalization. Predicting aortic annulus diameter pre-procedurally is crucial to managing patients with high-risk of PPM. Objectives To compare preoperative measurements of aortic annulus from echocardiography and CT scan with surgical sizing and develop an imaging-based algorithm to predict PPM. Methods From January 2017 to December 2020, patients underwent AVR at a teaching hospital were examined. The relationship between imaging measurements with operative values was assesed using scatter plots and Pearson’s correlation coefficient. Univariable linear regression was then used to build the predictive model. Results A total of 144 patients underwent AVR during the study period. Suture types and surgical approaches were not significantly associated with prosthesis size. CT scan-based measurements showed strong correlation with prosthesis size: mean diameter (R = 0.79), perimeter-derived diameter (R = 0.76), and area-derived diameter (R = 0.75). Mechanical valve and tissue valve shared similar correlation coefficients. Prosthesis size predictive models based on CT scan were 12.89 + 0.335 × d for mean diameter, 13.275 + 0.315 × d for perimeter-derived diameter and 13.626 + 0.309 × d for area-derived diameter. Conclusions Preoperative CT scan measurements are a reliable predictor of aortic prosthesis size. Transthoracic echocardiography is a possible alternative, though it is highly performer-dependent and unable to represent the aortic annulus fully. Together, these two imaging modalities can be used to quantitatively anticipate PPM preoperatively.https://doi.org/10.1186/s13019-021-01601-zProsthetic size predictorPatient-prothesis mismatchComputed tomographyTransthoracic echocardiography |
| spellingShingle | Anh Tuan Vo Tomomi Nakajima Trang Thi Thu Nguyen Nguyen Thoi Hai Nguyen Nga Bich Le Tri Huu Cao Dinh Hoang Nguyen Aortic prosthetic size predictor in aortic valve replacement Journal of Cardiothoracic Surgery Prosthetic size predictor Patient-prothesis mismatch Computed tomography Transthoracic echocardiography |
| title | Aortic prosthetic size predictor in aortic valve replacement |
| title_full | Aortic prosthetic size predictor in aortic valve replacement |
| title_fullStr | Aortic prosthetic size predictor in aortic valve replacement |
| title_full_unstemmed | Aortic prosthetic size predictor in aortic valve replacement |
| title_short | Aortic prosthetic size predictor in aortic valve replacement |
| title_sort | aortic prosthetic size predictor in aortic valve replacement |
| topic | Prosthetic size predictor Patient-prothesis mismatch Computed tomography Transthoracic echocardiography |
| url | https://doi.org/10.1186/s13019-021-01601-z |
| work_keys_str_mv | AT anhtuanvo aorticprostheticsizepredictorinaorticvalvereplacement AT tomominakajima aorticprostheticsizepredictorinaorticvalvereplacement AT trangthithunguyen aorticprostheticsizepredictorinaorticvalvereplacement AT nguyenthoihainguyen aorticprostheticsizepredictorinaorticvalvereplacement AT ngabichle aorticprostheticsizepredictorinaorticvalvereplacement AT trihuucao aorticprostheticsizepredictorinaorticvalvereplacement AT dinhhoangnguyen aorticprostheticsizepredictorinaorticvalvereplacement |