Three-dimensional transesophageal echocardiography of aortic-mitral valve coupling changes in patients with severe aortic stenosis after surgical aortic valve replacement and transcatheter aortic valve implantation

Abstract

Objective To study the morphologic and functional changes of the aortic-mitral valve coupling(AMC) after surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis (AS) using three-dimensional transesophageal echocardiography (3D-TEE). Methods Ninty-three severe AS patients were chosed as AS group in which 43 cases underwent SAVR and 50 cases underwent TAVI. TEE was performed before and after operation. Thirty-one age-and gender-matched patients who underwent 3D-TEE for exclusion of intracardiac thrombus were selected as control group. Cardiovascular quantitative analysis software was used to measure the parameters of aortic valve, mitral valve and AMC in the the control group, the SAVR group and the TAVI group before and after operation. Results ①Compared with control group, the antero posterior(AP) diameter of mitral value in AS group increased, the ellipticity of mitral valve decreased, the height of the mitral annulus increased(all P 0.05). ②After SAVR, the anterolateral-posteromedial diameter, AP diameter, perimeter and area of mitral valve decreased, the ellipticity of mitral valve increased(all P 0.05). ③After TAVI, the AP diameter, height, perimeter and area of mitral valve decreased, the ellipticity of mitral valve increased(all P 0.05). Conclusions After SAVR and TAVI, the anatomy and function of AMC in patients with severe AS changed to varying degrees after operation. It demonstrates that the impacts of both AS and repairment of AS on the mitral valve were. In addition, after SAVR and TAVI, the geometry and function of aortic and mitral valves of the patients recovered to some degrees. Key words: Echocardiography, transesophageal, three-dimensional; Aortic valve stenosis; Aortic-mitral valve coupling; Surgicar aortic valve replacement; Transcatheter aortic valve implantation