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von Knobelsdorff-Brenkenhoff, F; Rudolph, A; Wassmuth, R; Bohl, S; Buschmann, EE; Abdel-Aty, H; Dietz, R; Schulz-Menger, J.
Feasibility of cardiovascular magnetic resonance to assess the orifice area of aortic bioprostheses.
Circ Cardiovasc Imaging. 2009; 2(5): 397-404. Doi: 10.1161/CIRCIMAGING.108.840967 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Buschmann Eva Elina
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Abstract:
Prosthetic orifice area, usually calculated by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE), provides important information regarding the hemodynamic performance of aortic bioprostheses. However, both TTE and TEE have limitations; therefore accurate and reproducible determination of the orifice area often remains a challenge. The present study aimed to investigate the feasibility of cardiovascular magnetic resonance (CMR) to assess the orifice areas of aortic bioprostheses. CMR planimetry of the orifice area was performed in 65 patients (43/22 stented/stentless prostheses; mean time since implantation, 3.1+/-2.8 years; mean orifice area [TTE], 1.70+/-0.43 cm(2); 62 normally functioning prostheses, 2 severe stenoses, and 1 severe regurgitation) in an imaging plane perpendicular to the transprosthetic flow using steady-state free-precession cine imaging under breath-hold conditions on a 1.5-T MR system. CMR results were compared with TTE (continuity equation, n=65) and TEE (planimetry, n=31). CMR planimetry was readily feasible in 80.0%; feasible with limitation in 15.4% because of stent, flow, and sternal wire artifacts; and impossible in 4.6% because of flow artifacts. Correlations of the orifice areas by CMR with TTE (r=0.82) and CMR with TEE (r=0.92) were significant. The average difference between the methods was -0.02+/-0.24 cm(2) (TTE) and 0.05+/-0.15 cm(2) (TEE). Agreement was present for stented and stentless devices and independent of orifice size. Intraobserver and interobserver variabilities of CMR planimetry were 6.7+/-5.4% and 11.5+/-7.8%. The assessment of aortic bioprostheses with normal orifice areas by CMR is technically feasible and provides orifice areas with a close correlation to echocardiography and low observer dependency.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Aged -
Aged, 80 and over -
Aortic Valve - pathology
Aortic Valve - physiopathology
Aortic Valve - surgery
Aortic Valve Insufficiency - etiology
Aortic Valve Insufficiency - pathology
Aortic Valve Stenosis - etiology
Aortic Valve Stenosis - pathology
Bioprosthesis -
Echocardiography, Transesophageal -
Female -
Heart Valve Prosthesis -
Heart Valve Prosthesis Implantation - adverse effects
Heart Valve Prosthesis Implantation - instrumentation
Hemodynamics -
Humans -
Magnetic Resonance Imaging, Cine -
Male -
Middle Aged -
Observer Variation -
Prospective Studies -
Prosthesis Design -
Reproducibility of Results -
Stents -
Time Factors -

Find related publications in this database (Keywords)
imaging
MRI
echocardiography
valves
surgery
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