Aortic valve and aortic root features in CT angiography in patients considered for aortic valve repair
Abstract Background The underlying mechanism of aortic regurgitation and aortic valve and root characteristics are associated with the durability of surgical repair. Objective We investigated whether multidetector CT (MDCT) identifies the characteristics of the aortic valve and root that may be asso...
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Veröffentlicht in: | Journal of cardiovascular computed tomography 2014-07, Vol.8 (4), p.299-306 |
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creator | Regeer, Madelien V., MD Kamperidis, Vasileios, MD, MSc Versteegh, Michel I.M., MD Klautz, Robert J.M., MD, PhD Scholte, Arthur J.H.A., MD, PhD Bax, Jeroen J., MD, PhD Schalij, Martin J., MD, PhD Marsan, Nina Ajmone, MD, PhD Delgado, Victoria, MD, PhD |
description | Abstract Background The underlying mechanism of aortic regurgitation and aortic valve and root characteristics are associated with the durability of surgical repair. Objective We investigated whether multidetector CT (MDCT) identifies the characteristics of the aortic valve and root that may be associated with the ability to perform successful surgical repair. Methods Sixty-one patients with aortic regurgitation and/or aortic root pathology who were evaluated for aortic valve or root repair and underwent clinically indicated gated or nongated MDCT of the aortic valve and aortic root were included in the present analysis. Patients with endocarditis were excluded. MDCT data of aortic valve anatomy and calcification and thoracic aorta dimensions were analyzed. Results The aortic valve and root was successfully repaired in 36 patients (55 ± 13 years; 61% male; median EuroSCORE II, 3.8%) whereas in 25 patients (56 ± 15 years; 52% male; median EuroSCORE II, 2.5%) repair was not attempted (n = 20) or valve repair was converted to aortic valve replacement during surgery (n = 5). In patients in whom repair was considered not possible or failed, there was a higher percentage of bicuspid aortic valves (48% vs 17%; P = .019), more severe commissural calcification, and more severe annular calcification. Conclusion The degree of commissural and annular calcification of the aortic valve determined by MDCT is inversely related to the ability to perform surgical valve repair instead of replacement. Similarly, bicuspid valve anatomy predicts failure to perform repair. |
doi_str_mv | 10.1016/j.jcct.2014.06.008 |
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Objective We investigated whether multidetector CT (MDCT) identifies the characteristics of the aortic valve and root that may be associated with the ability to perform successful surgical repair. Methods Sixty-one patients with aortic regurgitation and/or aortic root pathology who were evaluated for aortic valve or root repair and underwent clinically indicated gated or nongated MDCT of the aortic valve and aortic root were included in the present analysis. Patients with endocarditis were excluded. MDCT data of aortic valve anatomy and calcification and thoracic aorta dimensions were analyzed. Results The aortic valve and root was successfully repaired in 36 patients (55 ± 13 years; 61% male; median EuroSCORE II, 3.8%) whereas in 25 patients (56 ± 15 years; 52% male; median EuroSCORE II, 2.5%) repair was not attempted (n = 20) or valve repair was converted to aortic valve replacement during surgery (n = 5). In patients in whom repair was considered not possible or failed, there was a higher percentage of bicuspid aortic valves (48% vs 17%; P = .019), more severe commissural calcification, and more severe annular calcification. Conclusion The degree of commissural and annular calcification of the aortic valve determined by MDCT is inversely related to the ability to perform surgical valve repair instead of replacement. Similarly, bicuspid valve anatomy predicts failure to perform repair.</description><identifier>ISSN: 1934-5925</identifier><identifier>EISSN: 1876-861X</identifier><identifier>DOI: 10.1016/j.jcct.2014.06.008</identifier><identifier>PMID: 25151922</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aorta, Thoracic - diagnostic imaging ; Aorta, Thoracic - surgery ; Aortic regurgitation ; Aortic root pathology ; Aortic root replacement ; Aortic Valve - abnormalities ; Aortic Valve - diagnostic imaging ; Aortic Valve - physiopathology ; Aortic Valve - surgery ; Aortic Valve Insufficiency - diagnostic imaging ; Aortic Valve Insufficiency - physiopathology ; Aortic Valve Insufficiency - surgery ; Aortic valve repair ; Aortography - methods ; Blood Vessel Prosthesis Implantation ; Calcinosis - diagnostic imaging ; Calcinosis - surgery ; Cardiac Surgical Procedures ; Cardiac-Gated Imaging Techniques ; Cardiovascular ; Computed tomography ; Female ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; Patient Selection ; Predictive Value of Tests ; Retrospective Studies ; Severity of Illness Index</subject><ispartof>Journal of cardiovascular computed tomography, 2014-07, Vol.8 (4), p.299-306</ispartof><rights>Society of Cardiovascular Computed Tomography</rights><rights>2014 Society of Cardiovascular Computed Tomography</rights><rights>Copyright © 2014 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-af9a30347274b3435672fde4309fd398c12b37e507ab909b29c6bc45f522d9a23</citedby><cites>FETCH-LOGICAL-c411t-af9a30347274b3435672fde4309fd398c12b37e507ab909b29c6bc45f522d9a23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcct.2014.06.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25151922$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Regeer, Madelien V., MD</creatorcontrib><creatorcontrib>Kamperidis, Vasileios, MD, MSc</creatorcontrib><creatorcontrib>Versteegh, Michel I.M., MD</creatorcontrib><creatorcontrib>Klautz, Robert J.M., MD, PhD</creatorcontrib><creatorcontrib>Scholte, Arthur J.H.A., MD, PhD</creatorcontrib><creatorcontrib>Bax, Jeroen J., MD, PhD</creatorcontrib><creatorcontrib>Schalij, Martin J., MD, PhD</creatorcontrib><creatorcontrib>Marsan, Nina Ajmone, MD, PhD</creatorcontrib><creatorcontrib>Delgado, Victoria, MD, PhD</creatorcontrib><title>Aortic valve and aortic root features in CT angiography in patients considered for aortic valve repair</title><title>Journal of cardiovascular computed tomography</title><addtitle>J Cardiovasc Comput Tomogr</addtitle><description>Abstract Background The underlying mechanism of aortic regurgitation and aortic valve and root characteristics are associated with the durability of surgical repair. Objective We investigated whether multidetector CT (MDCT) identifies the characteristics of the aortic valve and root that may be associated with the ability to perform successful surgical repair. Methods Sixty-one patients with aortic regurgitation and/or aortic root pathology who were evaluated for aortic valve or root repair and underwent clinically indicated gated or nongated MDCT of the aortic valve and aortic root were included in the present analysis. Patients with endocarditis were excluded. MDCT data of aortic valve anatomy and calcification and thoracic aorta dimensions were analyzed. Results The aortic valve and root was successfully repaired in 36 patients (55 ± 13 years; 61% male; median EuroSCORE II, 3.8%) whereas in 25 patients (56 ± 15 years; 52% male; median EuroSCORE II, 2.5%) repair was not attempted (n = 20) or valve repair was converted to aortic valve replacement during surgery (n = 5). In patients in whom repair was considered not possible or failed, there was a higher percentage of bicuspid aortic valves (48% vs 17%; P = .019), more severe commissural calcification, and more severe annular calcification. Conclusion The degree of commissural and annular calcification of the aortic valve determined by MDCT is inversely related to the ability to perform surgical valve repair instead of replacement. Similarly, bicuspid valve anatomy predicts failure to perform repair.</description><subject>Adult</subject><subject>Aged</subject><subject>Aorta, Thoracic - diagnostic imaging</subject><subject>Aorta, Thoracic - surgery</subject><subject>Aortic regurgitation</subject><subject>Aortic root pathology</subject><subject>Aortic root replacement</subject><subject>Aortic Valve - abnormalities</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - physiopathology</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Insufficiency - diagnostic imaging</subject><subject>Aortic Valve Insufficiency - physiopathology</subject><subject>Aortic Valve Insufficiency - surgery</subject><subject>Aortic valve repair</subject><subject>Aortography - methods</subject><subject>Blood Vessel Prosthesis Implantation</subject><subject>Calcinosis - diagnostic imaging</subject><subject>Calcinosis - surgery</subject><subject>Cardiac Surgical Procedures</subject><subject>Cardiac-Gated Imaging Techniques</subject><subject>Cardiovascular</subject><subject>Computed tomography</subject><subject>Female</subject><subject>Heart Valve Prosthesis Implantation</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multidetector Computed Tomography</subject><subject>Patient Selection</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><issn>1934-5925</issn><issn>1876-861X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtr3TAQRkVpaR7tH-iieNmNHT1tC0ogXNImEOiiKXQnZGmUyPG1XMm-cP99ZZx0kUVXEqNvzqAzCH0iuCKY1Bd91RszVxQTXuG6wrh9g05J29RlW5Pfb_NdMl4KScUJOkupx1g0BLfv0QkVRBBJ6SlyVyHO3hQHPRyg0KMt9FaIIcyFAz0vEVLhx2J3n58ffHiIeno8rpVJzx7GORUmjMlbiGALF-ILYUNGmLSPH9A7p4cEH5_Pc_Tr2_X97qa8-_H9dnd1VxpOyFxqJzXDjDe04R3jTNQNdRY4w9JZJltDaMcaELjRncSyo9LUneHCCUqt1JSdoy8bd4rhzwJpVnufDAyDHiEsSREhatqy7CVH6RY1MaQUwakp-r2OR0WwWv2qXq1-1epX4Vplv7np8zN_6fZg_7W8CM2Br1sA8i8PHqJKJksyYH2EDLPB_59_-ardDH70Rg9PcITUhyWO2Z8iKlGF1c91w-uCCceZmOf_BU0VoQY</recordid><startdate>20140701</startdate><enddate>20140701</enddate><creator>Regeer, Madelien V., MD</creator><creator>Kamperidis, Vasileios, MD, MSc</creator><creator>Versteegh, Michel I.M., MD</creator><creator>Klautz, Robert J.M., MD, PhD</creator><creator>Scholte, Arthur J.H.A., MD, PhD</creator><creator>Bax, Jeroen J., MD, PhD</creator><creator>Schalij, Martin J., MD, PhD</creator><creator>Marsan, Nina Ajmone, MD, PhD</creator><creator>Delgado, Victoria, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140701</creationdate><title>Aortic valve and aortic root features in CT angiography in patients considered for aortic valve repair</title><author>Regeer, Madelien V., MD ; Kamperidis, Vasileios, MD, MSc ; Versteegh, Michel I.M., MD ; Klautz, Robert J.M., MD, PhD ; Scholte, Arthur J.H.A., MD, PhD ; Bax, Jeroen J., MD, PhD ; Schalij, Martin J., MD, PhD ; Marsan, Nina Ajmone, MD, PhD ; Delgado, Victoria, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-af9a30347274b3435672fde4309fd398c12b37e507ab909b29c6bc45f522d9a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aorta, Thoracic - diagnostic imaging</topic><topic>Aorta, Thoracic - surgery</topic><topic>Aortic regurgitation</topic><topic>Aortic root pathology</topic><topic>Aortic root replacement</topic><topic>Aortic Valve - abnormalities</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - physiopathology</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Insufficiency - diagnostic imaging</topic><topic>Aortic Valve Insufficiency - physiopathology</topic><topic>Aortic Valve Insufficiency - surgery</topic><topic>Aortic valve repair</topic><topic>Aortography - methods</topic><topic>Blood Vessel Prosthesis Implantation</topic><topic>Calcinosis - diagnostic imaging</topic><topic>Calcinosis - surgery</topic><topic>Cardiac Surgical Procedures</topic><topic>Cardiac-Gated Imaging Techniques</topic><topic>Cardiovascular</topic><topic>Computed tomography</topic><topic>Female</topic><topic>Heart Valve Prosthesis Implantation</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multidetector Computed Tomography</topic><topic>Patient Selection</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Regeer, Madelien V., MD</creatorcontrib><creatorcontrib>Kamperidis, Vasileios, MD, MSc</creatorcontrib><creatorcontrib>Versteegh, Michel I.M., MD</creatorcontrib><creatorcontrib>Klautz, Robert J.M., MD, PhD</creatorcontrib><creatorcontrib>Scholte, Arthur J.H.A., MD, PhD</creatorcontrib><creatorcontrib>Bax, Jeroen J., MD, PhD</creatorcontrib><creatorcontrib>Schalij, Martin J., MD, PhD</creatorcontrib><creatorcontrib>Marsan, Nina Ajmone, MD, PhD</creatorcontrib><creatorcontrib>Delgado, Victoria, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular computed tomography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Regeer, Madelien V., MD</au><au>Kamperidis, Vasileios, MD, MSc</au><au>Versteegh, Michel I.M., MD</au><au>Klautz, Robert J.M., MD, PhD</au><au>Scholte, Arthur J.H.A., MD, PhD</au><au>Bax, Jeroen J., MD, PhD</au><au>Schalij, Martin J., MD, PhD</au><au>Marsan, Nina Ajmone, MD, PhD</au><au>Delgado, Victoria, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aortic valve and aortic root features in CT angiography in patients considered for aortic valve repair</atitle><jtitle>Journal of cardiovascular computed tomography</jtitle><addtitle>J Cardiovasc Comput Tomogr</addtitle><date>2014-07-01</date><risdate>2014</risdate><volume>8</volume><issue>4</issue><spage>299</spage><epage>306</epage><pages>299-306</pages><issn>1934-5925</issn><eissn>1876-861X</eissn><abstract>Abstract Background The underlying mechanism of aortic regurgitation and aortic valve and root characteristics are associated with the durability of surgical repair. Objective We investigated whether multidetector CT (MDCT) identifies the characteristics of the aortic valve and root that may be associated with the ability to perform successful surgical repair. Methods Sixty-one patients with aortic regurgitation and/or aortic root pathology who were evaluated for aortic valve or root repair and underwent clinically indicated gated or nongated MDCT of the aortic valve and aortic root were included in the present analysis. Patients with endocarditis were excluded. MDCT data of aortic valve anatomy and calcification and thoracic aorta dimensions were analyzed. Results The aortic valve and root was successfully repaired in 36 patients (55 ± 13 years; 61% male; median EuroSCORE II, 3.8%) whereas in 25 patients (56 ± 15 years; 52% male; median EuroSCORE II, 2.5%) repair was not attempted (n = 20) or valve repair was converted to aortic valve replacement during surgery (n = 5). In patients in whom repair was considered not possible or failed, there was a higher percentage of bicuspid aortic valves (48% vs 17%; P = .019), more severe commissural calcification, and more severe annular calcification. Conclusion The degree of commissural and annular calcification of the aortic valve determined by MDCT is inversely related to the ability to perform surgical valve repair instead of replacement. Similarly, bicuspid valve anatomy predicts failure to perform repair.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25151922</pmid><doi>10.1016/j.jcct.2014.06.008</doi><tpages>8</tpages></addata></record> |
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subjects | Adult Aged Aorta, Thoracic - diagnostic imaging Aorta, Thoracic - surgery Aortic regurgitation Aortic root pathology Aortic root replacement Aortic Valve - abnormalities Aortic Valve - diagnostic imaging Aortic Valve - physiopathology Aortic Valve - surgery Aortic Valve Insufficiency - diagnostic imaging Aortic Valve Insufficiency - physiopathology Aortic Valve Insufficiency - surgery Aortic valve repair Aortography - methods Blood Vessel Prosthesis Implantation Calcinosis - diagnostic imaging Calcinosis - surgery Cardiac Surgical Procedures Cardiac-Gated Imaging Techniques Cardiovascular Computed tomography Female Heart Valve Prosthesis Implantation Humans Male Middle Aged Multidetector Computed Tomography Patient Selection Predictive Value of Tests Retrospective Studies Severity of Illness Index |
title | Aortic valve and aortic root features in CT angiography in patients considered for aortic valve repair |
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