Application value of real-time three-dimensional transesophageal echocardiography in transcatheter aortic valve implantation in patients with bicuspid aortic valve stenosis

Abstract

Objective To investigate the value of three-dimensional transesophageal echocardiography(3DTEE) in transcatheter aortic valve implantation(TAVI) in patients with bicuspid aortic stenosis. Methods Nine patients with se vere aortic stenosis [aortic valve area (AVA) 40 mmHg] were enrolled.All patients received 2D-transthoracic echocardiograhy(2DTTE), 2DTEE, 3DTEE examination before, during and after TAVI. Results Successful TAVI was achieved in all patients [AVPG from (105.01±17.55)mmHg reduce to (22.67±5.81)mmHg]. 2DTEE-derived aortic valve annulus dimension (AVAD) was significantly smaller compared with that derived by multi-slice computed tomography (MSCT) [(22.3±1.1)mm vs (24.2±1.2mm, P=0.0018], and they were moderately correlated( r=0.69, P 0.05) before TAVI. The morphology of prosthetic aortic ring after TAVI was elliptic in all patients, but the valve open and close were good. Conclusions 2DTEE-derived AVAD was inaccurate in patients with bicuspid aortic valve stenosis. 3DTEE and MSCT-derived AVAD, AVAA and AVA had no significant difference. The prosthetic aortic ring was elliptic by 2DTEE and 3DTEE after TAVI with normal function. Key words: Echocardiography, transesophageal; Echocardiography, three-dimensional; Aortic stenosis; Heart valve prosthesis implantation