Uloga transezofagealne ehokardiografije u planimetrijskoj proceni značajnosti izolovane aortne stenoze

Abstract

Cilj studije je da se ispita mogućnost primene planimetrijske transezofagealne metode (TEE) upotrebom multipleinske transezofagealne (TEE) sonde za pouzdano utvrđivanje površine ušća aortne valvule (AVA) u aortnoj stenozi (AS). Rotacijom multipleinske sonde dobija se presek površine i mogućnost centriranja pregleda u dugoj osi stenotične valvule i precizan pregled u kratkoj osi bez pokretanja vrha sonde. Tako se može prikazati AVA u preseku i na nivou duge ose. Rezultati merenja TEE-AVA metodom su poređeni sa podatcima dobijenim invazivnim merenjem u toku kateterizacije upotrebom Gorlinove formule i podatcima dobijenim korišćenjem neinvazivne planimetrijske transtorakalne (TTE-AVA) metode upotrebom kontinuirane jednačine. AVA je merena planimetrijskom metodom upotrebom multipleinske TEE sonde kod 54 pacijenta (65(36-85) god)sa poznatom kalcifikovanom aortnom stenozom. Ispitivanje je obuhvatilo 25 muškaraca i 29 žena. Kod tri pacijenta gde je AVA bila izrazito smanjena ( ≤ 0,4 cm²), primenom TEE nije bilo moguće egzaktno proceniti AVA i ona je mogla biti određena samo Gorlinovom formulom. Postoji značajna korelacija između TEE-AVA (0.885(0.76) cm²) i podataka dobijenih priemnom Gorlinove formule (0.689(0.58) cm²)(r= 0.402; p<0.01).Postoji značajna korelacija AVA određene Gorlinovom metodom i TTE-AVA (0.689(0.58) cm²) (r= 0.298; p<0.05). Multiplein planimetrijska TEE metoda je praktična i pouzdana klinička metoda za procenu značajnosti AS.

The aim of the study was to assess if the aortic valve orifice area (AVA) can be precisly assessed with planimetric transeesophageal (TEE) method using multiplain transesophageal probe in patients with aortic stenosis (AS).Multiplain probe can be rotated and this gives better assessment of area and possibility for focusing in t he l ong a xis o f s tenotic a ortic v alve a nd precise view in the short axis without additional probe movements. This method presents the aortic valve orifice area and also the view of AVA at the level of long axis. Data based on planimetric TEE (TEE-AVA) method using continuous equatation were compared with data obtained by using invasive catheterisation method based on Gorlin’s formula and AVA measured with transthoracic echocardiography method (TTE-AVA). The study included 54 patients (65(36-85) ys), 25 man and 29 women with known AS. The AVA was assessed with with planimetric transeesophageal method using multiplain transesophageal probe (TEE-AVA). In three patients with severe AS (AVA ≤ 0,4 cm²) it was impossible to use planimetric TEE, so Gorlin’s formula was used. In our study, strong correlation exists between TEE-AVA (0.885(0.76) cm²) and AVA assessed with catheterisation and calculated with Gorlin’s formula (0.689(0.58) cm²) (r= 0.402; p<0.01). Signifficant correlation was found between AVA obtained by catheterisation and TTE-AVA (0.689(0.58) cm2) (r= 0.298; p<0.05). Multiplain planimetric TEE method is practical noninvasive method for preoperative AS assessment.