naa a22 4500 510742513 CHVBK 20180411083033.0 cr unu---uuuuu 180411e20130101xx s 000 0 eng 10.1007/s12630-012-9819-0 doi (NATIONALLICENCE)springer-10.1007/s12630-012-9819-0 Measuring aortic valve coaptation surface area using three-dimensional transesophageal echocardiography [Elektronische Daten] [Benjamin Sohmer, Christopher Hudson, Juliet Atherstone, A. Lambert, Michel Labrosse, Munir Boodhwani] Mesure de la surface de coaptation d'une valve aortique grâce à l'échocardiographie transœsophagienne tridimensionnelle Background: As aortic valve (AV) repairs become more sophisticated, surgeons need increasingly detailed information about the structure and function of this valve. Unlike two-dimensional transesophageal echocardiography (2D-TEE), using three-dimensional (3D)-TEE makes it possible to image the entire AV. We hypothesized that measuring coaptation surface area (CoapSA) would be feasible and reproducible, and CoapSA would decrease in patients with aortic insufficiency. Methods: We developed a new technique to calculate the AV-CoapSA using 3D-TEE. We measured the coaptation surfaces between the right coronary cusp/left coronary cusp, right coronary cusp/non-coronary cusp, and left coronary cusp/non-coronary cusp in ten normal AVs and ten AVs with moderate-severe aortic insufficiency (AI). Since computer models have previously shown that CoapSA is trapezoidal, we used the formula: trapezoid area=length×(medial coaptation height+lateral coaptation height)/2. The total CoapSA was calculated by adding all three areas. To adjust for valve size, we indexed the value to the diameter of the ventricular aortic junction (VAJ). Measurements were performed by two observers. Results: The intra-observer correlation was 0.84 for one observer (P<0.0001) and 0.93 for the other (P<0.0001). The inter-observer correlation was 0.87 (P<0.0001). In normal valves, the CoapSA [mean total (standard deviation)] was significantly greater than in the insufficient valves [1.61 (0.31)cm2 vs 1.03 (0.22)cm2, respectively; P<0.001]. After indexing for the VAJ diameter, the total CoapSA remained significantly greater in normal valves than in insufficient valves. Conclusion: In this proof of concept study, we present a new and innovative technique to measure AV-CoapSA using 3D-TEE. It is reproducible and shows decreased CoapSA in patients with AI. Coaptation surface area may provide insight into mechanisms of AI and may have predictive value following AV repair. Canadian Anesthesiologists' Society, 2012 Sohmer Benjamin Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street Suite H2410, K1Y 4W7, Ottawa, ON, Canada aut Hudson Christopher Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street Suite H2410, K1Y 4W7, Ottawa, ON, Canada aut Atherstone Juliet Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street Suite H2410, K1Y 4W7, Ottawa, ON, Canada aut Lambert A. Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street Suite H2410, K1Y 4W7, Ottawa, ON, Canada aut Labrosse Michel Department of Mechanical Engineering, University of Ottawa, 161 Louis Pasteur, Colonel By Hall A213, Ottawa, ON, Canada aut Boodhwani Munir Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, K1Y 4W7, Ottawa, ON, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/1(2013-01-01), 24-31 0832-610X 60:1<24 2013 60 12630 https://doi.org/10.1007/s12630-012-9819-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9819-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sohmer Benjamin Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street Suite H2410, K1Y 4W7, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Hudson Christopher Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street Suite H2410, K1Y 4W7, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Atherstone Juliet Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street Suite H2410, K1Y 4W7, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Lambert A. Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street Suite H2410, K1Y 4W7, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Labrosse Michel Department of Mechanical Engineering, University of Ottawa, 161 Louis Pasteur, Colonel By Hall A213, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Boodhwani Munir Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, K1Y 4W7, Ottawa, ON, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/1(2013-01-01), 24-31 0832-610X 60:1<24 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer