预测与观察到的门到冠状动脉距离在门内门TAVR:一个计算机断层扫描研究
Georgios Tzimas1, Mariama Akodad2, David Meier2
1Center for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
对于门内透导管大动脉置换 (ViV TAVR) 的程序前计算机断层扫描 (CT) 测量可能会低估TAVR后的距离,原因是扩张不足. 后扩张可以改变这些距离,影响准确性.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 术前计算机断层扫描 (CT) 用于预测在门内透导管大动脉置换 (ViV TAVR) 过程中冠状动脉阻塞风险.
- 在TAVR前评估虚拟透气管心脏到冠状动脉骨 (VTC) 和到鼻腔 (VTS) 的距离,以估计风险.
研究的目的:
- 评估预测VTC/VTS距离与实际TAVR后CT测量之间的一致性.
- 评估这些距离与透气管心脏门 (THV) 扩张和部署之间的关系.
主要方法:
- 研究了51名接受气球可扩展ViV TAVR的患者.
- 在四个层面上评估了THV支架扩张:输入,环,输出和THV输出.
- 在TAVR前CT (VTC/VTS) 和TAVR后CT测量结果进行了比较.
主要成果:
- 在ViV TAVR之后,THV支架通常没有扩展,特别是在环上.
- 与名义气球填充相比,扩张后显著增加了THV扩张.
- 观察到的距离与预测的距离不同:名义填充时较大,扩张后较小.
结论:
- 在TAVR前的VTC/VTS距离可能会低估TAVR后的距离,原因是THV在名义气球填充时不够扩张.
- 扩张后可能导致过度膨胀和距离小于预测,特别是在外流水平.
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