Value of Transesophageal Three-dimensional Echocardiography in Diagnosis of Perivalvular Leakage after Aortic Valve Replacement

Zhixuan LI; Shimeng ZHUANG; Zhao WANG; Xiaodan LI; Zhaohui WANG

doi:10.12259/j.issn.2095-610X.S20230612

Volume 44 Issue 6

Jun. 2023

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Article Navigation > Journal of Kunming Medical University > 2023 > 44(6): 81-85

Zhixuan LI, Shimeng ZHUANG, Zhao WANG, Xiaodan LI, Zhaohui WANG. Value of Transesophageal Three-dimensional Echocardiography in Diagnosis of Perivalvular Leakage after Aortic Valve Replacement[J]. Journal of Kunming Medical University, 2023, 44(6): 81-85. doi: 10.12259/j.issn.2095-610X.S20230612

Citation:

Zhixuan LI, Shimeng ZHUANG, Zhao WANG, Xiaodan LI, Zhaohui WANG. Value of Transesophageal Three-dimensional Echocardiography in Diagnosis of Perivalvular Leakage after Aortic Valve Replacement[J]. Journal of Kunming Medical University, 2023, 44(6): 81-85. doi: 10.12259/j.issn.2095-610X.S20230612

Citation:

Zhixuan LI, Shimeng ZHUANG, Zhao WANG, Xiaodan LI, Zhaohui WANG. Value of Transesophageal Three-dimensional Echocardiography in Diagnosis of Perivalvular Leakage after Aortic Valve Replacement[J]. Journal of Kunming Medical University, 2023, 44(6): 81-85. doi: 10.12259/j.issn.2095-610X.S20230612

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Value of Transesophageal Three-dimensional Echocardiography in Diagnosis of Perivalvular Leakage after Aortic Valve Replacement

doi: 10.12259/j.issn.2095-610X.S20230612

1.
School of Public Health，Jilin University，Changchun Jilin 130021
2.
Ultrasound Department，Siping Central People’s Hospital，Siping Jilin 136000
3.
Dept. of Neurology， Affiliated Hospital of Beihua University，Changchun Jilin 132001，China

Received Date: 2023-03-23
Available Online: 2023-06-19
Publish Date: 2023-06-25

Abstract

Abstract

Objective To explore the clinical value of transesophageal three-dimensional echocardiography （RT-3D-TEE） in the diagnosis of perivalvular leakage after aortic valve replacement. Methods 70 patients with suspectde perivalvular leak after aortic valve replacement in our hospital from January 2015 to December 2018 were selected.All patients underwent 2-D transthoracic echocardiography （2D-TTE） and RT-3D-TEE was compared. The accuracy of the two methods in the diagnosis of perivalvular leakage after aortic valve replacement, and the location, range and other conditions of perivalvular leakage were compared. All 70 patients underwent surgery again. Results After surgical treatment, 45 cases of perivalvular leakage and 25 cases of non-perivalvular leakage were confirmed.2D-TTE was diagnosed correctly in 52 cases, misdiagnosed in 9 case and missed in 9 cases. RT-3D-TEE was diagnosed correctly in 70 cases. The diagnostic accuracy of RT-3D-TEE （100.0%） was higher than that of 2D-TTE （80.0%）, and the difference was statistically significant （P < 0.05）. Among the 36 cases of perivalvular leakage diagnosed by 2D-TTE, 5 were located in the left coronary valve region, 8 were located in the right coronary valve region, 11 had multiple or larger than a single lobe region, and the remaining 12 cases could not be clearly identified. Among the 45 cases of perivalvular leakage diagnosed by RT-3D-TEE, 9 cases were located in the left coronary valve region, 15 cases were located in the right coronary valve region, 18 cases had multiple or larger than a single lobe region, and the remaining 3 cases could not be clearly identified. The location and scope of leakage in the diagnosis of RT-3D-TEE were basically consistent with the intraoperative observation.RT-3D-TEE diagnosed 9 patients with partial flap ring dislocation, 6 patients with perivalvular abscess, and 3 patients with mechanical mitral valve sticking, which was consistent with the intraoperative observation. 2D-TTE diagnosed 6 patients with partial flap ring dislocation, 3 patients with perivalvular abscess and 3 patients with mechanical mitral valve sticking were misdiagnosed.There was no significant difference in the length and width of perivalvular leakage between the two methods （P > 0.05）. The diagnostic accuracy of RT-3D-TEE was higher than that of 2D-TTE in the diagnosis of ring dislocation, perivalvular abscess and mechanical mitral valve valves. Conclusion RT-3D-TEE is a good complement to 2D-TTE in the diagnosis of perivalvular leakage after aortic valve replacement because of its superiority in the overall image of prosthetic valve because of its special observation position.
- Artificial aortic valve replacement,
- Perivalvular leak,
- Transesophageal three-dimensional echocardiography

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