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Date Published: 26/04/2024
Online Published: 02/05/2024
Abstract Views: 943
Views PDF: 46
DOI: https://doi.org/10.47972/vjcts.v46i.1129
Issue
Vol. 46
Section
Research Article
How to Cite
Nguyen, T. D., Ngo, V. H., Nguyen, M. N., & Nguyen, S. H. (2024). Evaluation of echocardiography and computed tomography characteristics related to aortic valve replacement technique through the right anterior thoracotomy at the 2nd intercostal space. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 46, 44 - 51. https://doi.org/10.47972/vjcts.v46i.1129

Evaluation of echocardiography and computed tomography characteristics related to aortic valve replacement technique through the right anterior thoracotomy at the 2nd intercostal space

Tien Dong Nguyen , Vi Hai Ngo, Minh Ngoc Nguyen, Sinh Hien Nguyen

Main Article Content

Abstract

Objective: evaluate echocardiographic and computed tomography characteristics related to minimally invasive aortic valve replacement technique through the right anterior thoracotomy at the 2nd intercostal space.


Methods: study on 74 patients undergoing aortic valve replacement surgery through the right anterior thoracotomy at the 2nd intercostal space at Hanoi Heart Hospital and 108 Military Central Hospital, from October 2019 to December 2022. Patients underwent preoperative echocardiography and multiple slices computed tomography to assess the lessons of aortic valve, valve annulus diameter, and intercostal space width.


Results: The ratio of aortic valve stenosis is 55.4%, stenosis combined with regurgitation is 31.1%, and aortic regurgitation is 13.5%. The average valve annulus diameter on computed tomography scans is 26.5 ± 3.1 mm (smallest 20; largest 36); average 2nd intercostal space width 18.1 ± 3.1 mm (smallest 11; largest 25). Valve annulus diameter measured by computed tomography correlates closely with actual prosthetic valve size (r = 0.54, p < 0.001); measured by echocardiography had a weak correlation and not statistically significant. The prosthetic valve size to be replaced is smaller than the valve annulus diameter measured on computed tomography, with an average of 4.8 ± 2.7 mm in aortic valve stenosis, 5.7 ± 2.0 mm in combined stenosis and regurgitation, and 7.2 ± 2.9 mm in aortic regurgitation, in which the difference between valve stenosis and regurgitation is statistically significant (p = 0.01).


Conclusions: Minimally invasive aortic valve replacement technique through the 2nd intercostal space right thoracotomy, with cutting the 3rd rib, is suitable for Vietnamese anatomy. Valve annulus diameter measured by computed tomography has a good linear correlation and can be a predictor for prosthetic valve size before surgery.

Article Details

Keywords

aortic valve replacement, minimally invasive surgery, right anterior thoracotomy, multiple slices computed tomography

References

1. Chang C, Raza S, Altarabsheh SE, et al. Minimally Invasive Approaches to Surgical Aortic Valve Replacement: A Meta-Analysis. The Annals of thoracic surgery. Dec 2018;106(6):1881-1889. doi:10.1016/j.athoracsur.2018.07.018
2. Glauber M, Miceli A, Gilmanov D, et al. Right anterior minithoracotomy versus conventional aortic valve replacement: a propensity score matched study. The Journal of thoracic and cardiovascular surgery. May 2013;145(5):1222-6. doi:10.1016/j.jtcvs.2012.03.064
3. Tavakoli R, Leprince P, Gassmann M, et al. Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement. Journal of visualized experiments : JoVE. Mar 26 2018;(133)doi:10.3791/57323
4. Khan I, Smith J, Trehan N. Minimally Invasive Right Anterior Mini-Thoracotomy Aortic Valve Replacement. Cardiac Surgery Procedures. 2019.
5. Del Giglio M, Mikus E, Nerla R, et al. Right anterior mini-thoracotomy vs. conventional sternotomy for aortic valve replacement: a propensity-matched comparison. Journal of thoracic disease. 2018;10(3):1588-1595. doi:10.21037/jtd.2018.03.47
6. Stolinski J, Plicner D, Grudzien G, et al. Computed Tomography Helps to Plan Minimally Invasive Aortic Valve Replacement Operations. The Annals of thoracic surgery. May 2016;101(5):1745-52. doi:10.1016/j.athoracsur.2015.10.076
7. Gilmanov D, Miceli A, Bevilacqua S, et al. Sutureless implantation of the perceval s aortic valve prosthesis through right anterior minithoracotomy. The Annals of thoracic surgery. Dec 2013;96(6):2101-8. doi:10.1016/j.athoracsur.2013.07.007
8. Nguyễn Tiến Đông, Nguyễn Sinh Hiền, Ngô Vi Hải, sự vc. Tiêu chí lựa chọn bệnh nhân trong phẫu thuật thay van động mạch chủ ít xâm lấn qua đường mở ngực trước phải dựa trên hình ảnh chụp cắt lớp vi tính. Tạp chí y dược học lâm sàng 108. 2021;16(No1):72-77.
9. Bouchot O, Petrosyan A, Morgant MC, Malapert G. Technical points for aortic valve replacement through right anterior minithoracotomy. European Journal of Cardio-Thoracic Surgery. 2018;53(suppl_2):ii24-ii26. doi:10.1093/ejcts/ezy105
10. Abud B, Saydam O, Engin AY, Karaarslan K, Kunt AG, Karacelik M. Outcomes of Aortic Valve Replacement Via Right Anterior Minithoracotomy and Central Cannulation Versus Conventional Aortic Valve Replacement in Obese Patients. Brazilian journal of cardiovascular surgery. Dec 1 2022;37(6):875-882. doi:10.21470/1678-9741-2021-0098
11. Bertaso AG, Wong DT, Liew GY, et al. Aortic annulus dimension assessment by computed tomography for transcatheter aortic valve implantation: differences between systole and diastole. The international journal of cardiovascular imaging. Dec 2012;28(8):2091-8. doi:10.1007/s10554-012-0018-4
12. Ingimarsdóttir IJ, Hellgren Johansson L, Flachskampf FA. Preoperative aortic annulus size assessment by transthoracic echocardiography compared to the size of surgically implanted aortic prostheses. Echo research and practice. Jun 1 2019;6(2):37-41. doi:10.1530/erp-19-0010
13. Vo AT, Nakajima T, Nguyen TTT, et al. Aortic prosthetic size predictor in aortic valve replacement. J Cardiothorac Surg. Aug 4 2021;16(1):221. doi:10.1186/s13019-021-01601-z
14. Sharma P, Samal S, Chaudhary S, Saha D, Naqvi S, Geelani M. Comparison of Aortic Annulus Measurements by Echocardiography and CT Scan with the Intraoperative Valve Sizing. 04/27 2021;