医学
心脏病学
血流动力学
内科学
主动脉根
围手术期
主动脉
放射科
作者
Nelson H. Burbano-Vera,Andrej Alfirevic,Andrew M. Bauer,Brett J. Wakefield,Hani K. Najm,Eric E. Roselli,Justin T. Tretter
标识
DOI:10.1016/j.echo.2024.01.015
摘要
Improved strategies in aortic valvar-sparing operations appreciate the dynamic, three-dimensional complexity of the aortic root and its valve. This depends upon detailed four-dimensional imaging of not only the planar dimensions of the aortic root, but also quantitative assessment of the valvar leaflets and their competency. The zones of apposition and resulting hemodynamic ventriculo-arterial junction formed in diastole determines valvar competency. Current understanding and assessment of this junction is limited, often relying upon intraoperative direct surgical inspection. However, this direct inspection itself is limited by evaluation in a non-hemodynamic state with limited field of view. In this review, we discuss the anatomy of the aortic root, including its hemodynamic junction. We review current echocardiographic approaches towards interrogating the incompetent aortic valve for pre-surgical planning. Furthermore, we introduce and standardize a complimentary approach towards assessing this hemodynamic ventriculo-arterial junction by three-dimensional echocardiography to further personalize pre-surgical planning for aortic valve surgery.
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