Simple 2-dimensional anatomic model to predict the risk of coronary obstruction during transcatheter aortic valve replacement

Heitkemper, Megan; Sivakumar, Sri Krishna; Hatoum, Hoda; Dollery, Jennifer; Lilly, Scott; Dasi, Lakshmi Prasad

doi:10.1016/j.jtcvs.2020.01.085

Cited by 11 publications

(7 citation statements)

References 27 publications

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“…Modern technique of transcatheter aortic valve implantation (TAVI) in the preoperative protocol requires measuring the height of the right and left coronary arteries [3,6]. Underestimation of height can cause obstruction of the coronary artery [5].…”

Section: Discussionmentioning

confidence: 99%

Normal values of coronary arteries branching height in women

et al. 2021

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Morphometric analysis of the structures of the aortic bulb and coronary arteries is necessary for the planning of cardiac surgery and endovascular interventions. The aim of the study was to determine the height of the coronary arteries branching in healthy women of Lviv city and Lviv region and to determine the relationship between the height of the location of the orifice of the coronary artery with anthropometric indicators. Fifteen computed tomography images with contrast of female thorax without heart and ascending aortic lesions (normal) were selected for the study. The height of the upper and lower edges of the coronary arteries was measured; height of Valsalva sinuses. The comparison of the mean values was performed according to the Student’s t-test. The correlation between the observed variables (age, height, body weight, body mass index, body surface area, height of the sinuses of Valsalva) was calculated using the Pearson linear correlation method (r). According to the study, the population group consisted of persons of the second period of adulthood (46.67 %) and the elderly (53.33 %). According to the body mass index, 80 % were overweight or obese I-II degree. The mean height of the coronary artery orifice in women without structural changes of the heart and ascending aorta was: 11.19±1.96 mm for the left and 11.68±1.80 mm for the right. The height of the orifice of the right and left coronary arteries were almost the same, without statistical significance (p=0.26). Analysis of the correlation between the values of the height of the orifice of the coronary artery did not show a probable dependence on height, weight, age, body mass index and body surface area. There is a direct relationship between the parameters of the height of the lower edge of the right coronary artery and the height of the upper edge of the right coronary artery (r=+0.75, p=0.001) and between the value of the lower edge of the left coronary artery and the upper edge of the left coronary artery (r=+0.63, p=0.01). Thus, the analysis of the correlation between the values of the height of the orifice of the coronary artery in women in norm and anthropometric indicators did not show a significant relationship. There was no statistical significance between the indicators of the height of the orifice of the right and left coronary arteries in women.

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Section: Discussionmentioning

confidence: 99%

Normal values of coronary arteries branching height in women

et al. 2021

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“…24 Distally, the diameter of the vessel is gradually getting smaller, branching to the arterioles and capillaries. 25…”

Section: Discussionmentioning

confidence: 99%

Anatomy of the Aortic Root and the Coronary Ostia: CT Evaluation

Pidvalna¹,

Матешук-Вацеба²,

Beshley³

et al. 2021

JMS

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Introduction: as there is a growing number of percutaneous interventions, scrupulous attention and profound knowledge of the aortic root and neighboring structures is required. The objective of the study is to describe the anatomy of the aortic root and the coronary ostia in asymptomatic patients using CT. Methods: eighty-five patients without any clinical symptoms suggestive of the aortic root and coronary arteries diseases underwent contrast-enhanced MDCT. CT angiography was performed with a 64-row helical CT scanner after administration of the non-ionic, iodinated contrast agent. Results: CT angiography depicted the entire structure of the aortic root. The aortic root encompasses several distinct elements, namely the aortic annulus, the aortic valve leaflets and their (leaflet) attachments, the interleaflet triangles, the sinuses of Valsalva, the coronary arteries ostia and the sinotubular junction. CT angiography depicted the distance between the aortic annulus and the margins of the left and right coronary ostia. While carrying out the analysis, the precise description of the anatomy of the sinotubular junction and the valve leaflet attachments has to be made. Sinuses of Valsalva normally consist of the right, left and posterior cusps. Left and right coronary ostia are located below the upper margin of the cusps. Conclusion: When analyzing the anatomy of the aortic root and the coronary ostia, each entity should be examined separately. It is important to take into account the relationship between the structures the aortic root encompasses. Changes in the size of one structure cause the improper functioning of the adjacent ones.

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“…The right and left coronary arteries originate from the corresponding aortic sinuses. The height of the aortic sinuses and the height of the coronary arteries are important clinically when planning endovascular interventions [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

CT assessment of the height of the coronary arteries orifice location and the height of the aortic sinuses in women with structural changes in the coronary arteries

Pidvalna

Beshley²,

Матешук-Вацеба

2022

Rep. of Morph.

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The most common form of cardiovascular disease in Ukraine is coronary heart disease, which is characterized by damage to the coronary arteries. The height of the aortic sinuses and the height of the coronary arteries are assessed when planning interventional procedures and cardiac surgery. Computed tomography can verify structural changes in the coronary arteries and morphometrically evaluate the components of the aortic sac. The purpose of the study: to measure the height of the coronary arteries orifice; height of the aortic sinuses in women with structural changes of the coronary arteries using computed tomography and assess the interdependence of measurements with anthropometric indicators (age, height, weight, body mass index, body surface area). Computed tomography-angiography of the chest of females with coronary arteries were processed. Statistical analysis: Shapiro-Francia test (correctness of distribution), Student’s t-test (comparison of the height of the coronary arteries and the height of the aortic sinuses); Pearson’s linear correlation; Fisher’s multifactorial regression analysis. The study found a direct correlation between height and measurability in women with coronary artery disease. The value of the growth rate was directly correlated with the height of the right aortic sinus (r=0.85, p=0.001), with the height of the lower edge of the right coronary artery orifice (r=0.74, p=0.01), the height of the upper edge of the left coronary artery orifice (r=0.67, p=0.03), the height of the upper edge of the right coronary artery orifice (r=0.67, p=0.03). It is proved that with increasing body surface area, the parameters of the right aortic sinus decrease: the inverse strong correlation r=-0.83, p=0.002. Significant direct relationships have been established between most of the measured components of the aortic root. Multifactor regression analysis showed a proven strong effect of anthropometric data and age on the height of the right aortic sinus: R=0.96, at p=0.009 (according to Fisher). This made it possible to build a model for predicting the height of the right aortic sinus depending on anthropometric and age parameters. Thus, in women with structural lesions of the coronary arteries, the increase in height correlates with an increase in the height of the right aortic sinus, the height of the coronary arteries orifice. An increase in body surface area correlates with a decrease in the height of the right aortic sinus in women with structural lesions of the coronary arteries.

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Simple 2-dimensional anatomic model to predict the risk of coronary obstruction during transcatheter aortic valve replacement

Cited by 11 publications

References 27 publications

Normal values of coronary arteries branching height in women

Normal values of coronary arteries branching height in women

Anatomy of the Aortic Root and the Coronary Ostia: CT Evaluation

CT assessment of the height of the coronary arteries orifice location and the height of the aortic sinuses in women with structural changes in the coronary arteries

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