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学科主题: 临床医学
题名:
Tricuspid Annulus: A Three-Dimensional Deconstruction and Reconstruction
作者: Owais, Khurram; Taylor, Charles E.; Jiang, Luyang; Khabbaz, Kamal R.; Montealegre-Gallegos, Mario; Matyal, Robina; Gorman, Joseph H., III; Gorman, Robert C.; Mahmood, Feroze
刊名: ANNALS OF THORACIC SURGERY
发表日期: 2014-11-01
DOI: 10.1016/j.athoracsur.2014.07.005
卷: 98, 期:5, 页:1536-1542
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems ; Respiratory System ; Surgery
研究领域[WOS]: Cardiovascular System & Cardiology ; Respiratory System ; Surgery
关键词[WOS]: MITRAL-VALVE SURGERY ; REAL-TIME ; REGURGITATION ; REPAIR ; ECHOCARDIOGRAPHY ; ANNULOPLASTY ; DILATATION ; GEOMETRY
英文摘要:

Background. Before clinical manifestation of regurgitation, the tricuspid annulus dilates and flattens when right ventricular dysfunction is potentially reversible. That makes the case for a prophylactic tricuspid annuloplasty even in the absence of significant tricuspid regurgitation. Owing to the appreciation of the favorable prognostic value of tricuspid annuloplasty, the geometry of the normal tricuspid annulus merits critical analysis.

Methods. Three-dimensional transesophageal echocardiographic data from 26 patients were analyzed using Image Arena (TomTec, Munich, Germany) software. Cartesian coordinate data from tricuspid annuli were exported to MATLAB (Mathworks, Natick, MA) for further processing. Annular metrics related to size, shape, and motion were computed.

Results. The tricuspid annulus demonstrated significant changes in area (p < 0.01) and perimeter (p < 0.03) during the cardiac cycle, with maximum values attained at end diastole. There was significant correlation between two- and three-dimensional area changes, indicating true expansion in the annulus. The anterolateral region of the annulus demonstrated the greatest dynamism (p < 0.01), and the anteroseptal region showed the least. The anteroseptal region also displayed the most nonplanarity in the annulus. In addition, vertical translational motion was observed, with a mean distance of 11.3 +/- 3.7 mm between end systolic and end diastolic annular centroids.

Conclusions. The tricuspid annulus is a dynamic, multiplanar structure with heterogeneous regional behavior. These characteristics should be taken into account for optimal annuloplasty device design and efficacy. (C) 2014 by The Society of Thoracic Surgeons

语种: 英语
项目资助者: Ronald M. Weintraub, MD, Family Research Fund
WOS记录号: WOS:000344746600009
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/65031
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02215 USA
2.Harvard Univ, Sch Med, Div Cardiac Surg, Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA
3.Univ Louisiana Lafayette, Dept Mech Engn, Lafayette, LA USA
4.Peking Univ, Peoples Hosp, Dept Anesthesia, Beijing 100871, Peoples R China
5.Univ Penn, Perelman Sch Med, Gorman Cardiovasc Res Ctr, Philadelphia, PA 19104 USA

Recommended Citation:
Owais, Khurram,Taylor, Charles E.,Jiang, Luyang,et al. Tricuspid Annulus: A Three-Dimensional Deconstruction and Reconstruction[J]. ANNALS OF THORACIC SURGERY,2014,98(5):1536-1542.
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