Document Detail

Deformation dynamics and mechanical properties of the aortic annulus by 4-dimensional computed tomography insights into the functional anatomy of the aortic valve complex and implications for transcatheter aortic valve therapy.
MedLine Citation:
PMID:  22222074     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: The purpose of this study was to assess deformation dynamics and in vivo mechanical properties of the aortic annulus throughout the cardiac cycle.
BACKGROUND: Understanding dynamic aspects of functional aortic valve anatomy is important for beating-heart transcatheter aortic valve implantation.
METHODS: Thirty-five patients with aortic stenosis and 11 normal subjects underwent 256-slice computed tomography. The aortic annulus plane was reconstructed in 10% increments over the cardiac cycle. For each phase, minimum diameter, ellipticity index, cross-sectional area (CSA), and perimeter (Perim) were measured. In a subset of 10 patients, Young's elastic module was calculated from the stress-strain relationship of the annulus.
RESULTS: In both subjects with normal and with calcified aortic valves, minimum diameter increased in systole (12.3 ± 7.3% and 9.8 ± 3.4%, respectively; p < 0.001), and ellipticity index decreased (12.7 ± 8.8% and 10.3 ± 2.7%, respectively; p < 0.001). The CSA increased by 11.2 ± 5.4% and 6.2 ± 4.8%, respectively (p < 0.001). Perim increase was negligible in patients with calcified valves (0.56 ± 0.85%; p < 0.001) and small even in normal subjects (2.2 ± 2.2%; p = 0.01). Accordingly, relative percentage differences between maximum and minimum values were significantly smallest for Perim compared with all other parameters. Young's modulus was calculated as 22.6 ± 9.2 MPa in patients and 13.8 ± 6.4 MPa in normal subjects.
CONCLUSIONS: The aortic annulus, generally elliptic, assumes a more round shape in systole, thus increasing CSA without substantial change in perimeter. Perimeter changes are negligible in patients with calcified valves, because tissue properties allow very little expansion. Aortic annulus perimeter appears therefore ideally suited for accurate sizing in transcatheter aortic valve implantation.
Ashraf Hamdan; Victor Guetta; Eli Konen; Orly Goitein; Amit Segev; Ehud Raanani; Dan Spiegelstein; Ilan Hay; Elio Di Segni; Michael Eldar; Ehud Schwammenthal
Related Documents :
14980844 - Limited left thoracotomy for reoperative coronary artery bypass grafting without cardio...
9236344 - A survey on minimally invasive coronary artery bypass grafting.
21673474 - Takayasu arteritis with intracranial involvement mimicking epilepsy: case report and re...
17625964 - Pericardiectomy using the starfish heart positioner.
11357974 - Stent-graft treatment of dissecting aneurysm in association with aortic intramural hema...
712374 - Coincidental aneurysms with tumours of pituitary origin.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  59     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  119-27     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Heart Institute, Chaim Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer, Israel; Department of Radiology, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Hashomer, Israel.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Percutaneous aortic valve replacement vascular outcomes with a fully percutaneous procedure.
Next Document:  Acute and 12-month results with catheter-based mitral valve leaflet repair: the EVEREST II (Endovasc...