Abstract 750: Usefulness of Real-time Three-dimensional Echocardiography in Evaluating Aortic Root Diameters During Cardiac Cycle
Objectives: Preoperative evaluation of the aortic root is important for determining surgical strategy in patients with aortic valve disease. The purpose of this study is to clarify the usefulness of real-time three-dimensional echocardiography (3D-echo) for precise measurement of the aortic root diameters and for evaluation of aortic root dynamics during cardiac cycle.
Methods: Twenty-three patients with aortic stenosis (AS) and 37 normal controls were studied. With two-dimensional echocardiography (2D-echo), the diameter of aortic root (aortic annulus, Valsalva sinus, and sinotubular junction) were measured from parasternal long-axis view. With 3D-echo, a full-volume image was obtained from a parasternal window. Using off-line analysis software, long-axis and short-axis views of the aortic root were reconstructed from the full-volume image at each cardiac cycle as follows. The long-axis view was obtained as it crossed the center of the short-axis view, and the short-axis was obtained as it was perpendicular to the axis of aortic root at each level, monitoring each other’s view. The anteroposterior diameters of aortic root were measured from the short-axis view. In patients with AS, intraoperative measurement of the annular diameter was also investigated.
Results: The annular diameter measured by 3D-echo was larger than that by 2D-echo (end-diastole: 21.2±2.2 vs 19.6±2.0 mm, p<0.0001). In 19 patients with AS who underwent valve replacement, the annular diameter measured by 3D-echo was closer to intraoperative measurement than that by 2D-echo. The annular diameter was increasing during diastole, and the diameters of Valsalva sinus and sinotubular junction were increasing during systole. The change of the annular diameter during cardiac cycle was significantly smaller in patients with AS than in normal subjects. (2.0±2.2 vs 7.8±3.4%, p<0.0001).
Conclusions: 3D-echo is useful in quantitative evaluation of the aortic root, including dynamic changes during cardiac cycle.