The diagnostic value of transthoracic echocardiography in congenital bicuspid aortic valve with aortic coarctation

doi:10.3877/cma.j.issn.2095-655X.2017.01.006

Abstract

Abstract:

Objective

To study the value of transthoracic echocardiography(TTE) in diagnosing aortic coarctation on patients with congenital bicuspid aortic valve(BAV).

Methods

One hundred and thirty-eight patients with BAV who received operation in Zhongshan Hospital Affiliated to Fudan University between July 2011 and July 2016 were analyzed retrospectively.Forty patients underwent TTE as well as CTA before the operation.The results of TTE, computed tomography angiography (CTA) and operation were compared.

Results

In 138 patients with BAV, three patients were diagnosed as BAV with aortic coarctation.All of them were confirmed by CTA before the surgery.While, only one of the three patients was discovered by TTE before the surgical intervention.Patients with the diagnosis of CTA and TEE were 3/3 and 1/3 respectively.The difference between the two methods had no statistical significance (P=0.200). Three cases of BAV with coarctation were all transverse crack type.

Conclusions

The difference between two methods(TTE and CTA) on diagnosis of aortic coarctation with BAV do not have statistical significance. CTA is the golden standard of diagnosis of aortic coarctation.Therefore, BAV patients with the symptom of aortic coarctation may receive additional examination like CTA, especially for the transverse crack type.

Key words: Echocardiography, Bicuspid aortic valve, Transverse crack type, Aortic coarctation

Xiaoli Pei, Yuchen Xu, Feiyan Song, Chujie Zhang, Xianhong Shu, Leilei Cheng. The diagnostic value of transthoracic echocardiography in congenital bicuspid aortic valve with aortic coarctation[J]. Chinese Journal of Diagnostics(Electronic Edition), 2017, 05(01): 22-25.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhzdxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-655X.2017.01.006

https://zhzdxdzzz.cma-cmc.com.cn/EN/Y2017/V05/I01/22

Figures/Tables 3

References 9

[1]	Charitos EI,Hanke T,Karluss A, et al.New insights into bicuspid aortic valve disease: the elongated anterior mitral leaflet[J]. Eur J Cardiothorac Surg, 2013, 43(2): 367-370.
[2]	Zegdi R,Ciobotaru V,Huerre C, et al.Detecting aortic valve bicuspidy in patients with severe aortic valve stenosis：high diagnostic accuracy of colour Doppler transoesophageal echocardiography[J]. Interact Cardiovasc Thorac Surg, 2013, 16(1): 16-20.
[3]	Erbel R,Aboyans V,Boileau C, et al.2014 ESC Guidelines on the diagnosis and treatment of aortic diseases：Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult.The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2014, 35(41): 2873-2926.
[4]	Sievers HH,Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens[J]. J Thorac Cardiovasc Surg, 2007, 133(5): 1226-1233.
[5]	宋飞艳,程蕾蕾,陈永乐, 等. 实时三维超声心动图评价淋巴瘤患者蒽环类药物化疗后左心室亚临床功能的价值[J/CD]. 中华诊断学电子杂志, 2015, 3(3): 155-158.
[6]	范立,王春生,程蕾蕾. 超声心动图评估主动脉瓣置换术后早期并发症的临床应用[J/CD]. 中华诊断学电子杂志, 2014, 2(1): 1-8.
[7]	Fernandes SM,Sanders SP,Khairy P, et al.Morphology of bicuspid aortic valve in children and adolescents[J]. J Am Coll Cardiol, 2004, 44(8): 1648-1651.
[8]	Yoo SM,Lee HY,White CS. MDCT Evaluation of Acute Aortic Syndrome[J]. Thorac Surg Clin, 2010, 20(1): 149-165.
[9]	任兴香,王建华,刘梅, 等. 超声心动图与CT血管成像诊断主动脉缩窄的价值对比研究[J]. 中华医学超声杂志(电子版), 2014, 11(9): 732-736.

项目	例数	狭窄(n＝100)	关闭不全(n＝98)	狭窄合并关闭不全(n＝65)	钙化(n＝76)
横裂式	72	45(45.0)	51(52.0)	31(48.0)	35(46.0)
纵裂式	66	55(55.0)	47(48.0)	34(52.0)	41(54.0)

项目	例数	狭窄(n＝100)	关闭不全(n＝98)	狭窄合并关闭不全(n＝65)	钙化(n＝76)
横裂式	72	45(45.0)	51(52.0)	31(48.0)	35(46.0)
纵裂式	66	55(55.0)	47(48.0)	34(52.0)	41(54.0)

项目	范围	均数±标准差	正常值	超出正常值(例，%)
左室舒张末内径(mm)	38～95	56.80±12.05	35～56	61(44.2)
左室收缩末内径(mm)	21～77	38.67±11.05	23～35	74(53.6)
室间隔(mm)	6～21	11.56± 2.63	6～11	66(47.8)
左室后壁(mm)	6～17	11.07± 2.20	6～11	54(39.1)
左房前后径(mm)	24～59	42.20± 7.04	19～40	85(61.6)
主动脉窦部(mm)	23～71	36.52± 7.86	≤37	49(35.5)
升主动脉增宽(mm)	38～71	46.42± 6.91	≤37	101(73.2)
左室射血分数(%)	20～76	59.09±10.41	≥55	38(27.5)
肺动脉压力(mmHg)	24～107	39.56±13.78	<40	51(37.0)

项目	范围	均数±标准差	正常值	超出正常值(例，%)
左室舒张末内径(mm)	38～95	56.80±12.05	35～56	61(44.2)
左室收缩末内径(mm)	21～77	38.67±11.05	23～35	74(53.6)
室间隔(mm)	6～21	11.56± 2.63	6～11	66(47.8)
左室后壁(mm)	6～17	11.07± 2.20	6～11	54(39.1)
左房前后径(mm)	24～59	42.20± 7.04	19～40	85(61.6)
主动脉窦部(mm)	23～71	36.52± 7.86	≤37	49(35.5)
升主动脉增宽(mm)	38～71	46.42± 6.91	≤37	101(73.2)
左室射血分数(%)	20～76	59.09±10.41	≥55	38(27.5)
肺动脉压力(mmHg)	24～107	39.56±13.78	<40	51(37.0)

[1]	Wanwei Zhang, Yunyun Qin, Qizhe Cai, Mingming Lin, Runyu Tian, Shan Jin, Xiuzhang Lyu. Value of myocardial early systolic lengthening in non-ST-segment elevation acute coronary syndrome for predicting severe coronary artery stenosis [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1016-1022.
[2]	Shutang Ren, Xiaocheng Liu, Yadong Zhang, Jiaying Sun, Ping Chen, Jianhua Zhou, Jin Long, Yunzhou Huang. Echocardioimagedata features of solo-systolic aortic regurgitation during left ventricular assist device support [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1023-1028.
[3]	Jinmei He, Lixue Yin, Jing Tan, Wenjun Zhang, Rui Wang, Mei Ren, Mingjiao Liao. Evaluation of potential left ventricular systolic dysfunction in patients with type 2 diabetes mellitus using ultrasonic myocardial work technology [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1029-1035.
[4]	Yanling Xue, Xiaojing Ma, Shurui Xie, Jun He, Juan Xia, Yafeng He. Application value of left ventricular opacification in acute myocardial infarction with ventricular septal rupture [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1036-1039.
[5]	Xining Wu, Yunshu Ouyang, Yixiu Zhang, Hua Meng, Zhonghui Xu, Peipei Zhang, Ke Lyu. Application of fetal echocardiography in prenatal management of fetuses with positive maternal anti-SSA/Ro-SSB/La antibodies [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1056-1060.
[6]	Shuihua Yang, Guidan He, Guican Qin, Mengfeng Liang, Yanhe Luo, Xueqin Li, Juansong Tang. Echocardioimagedata characteristics of fetal isolated total anomalous pulmonary venous connection and application of high definition flow imaging and spatio-temporal image correlation [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1061-1067.
[7]	Baofu Zhang, Jin Yu, Jingjing Ye, Jiangen Yu, Xiaohui Ma, Xiwang Liu. Echocardioimagedata diagnosis of anomalous pulmonary venous connection caused by congenital malposition of the septum primum [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1074-1080.
[8]	Hongjuan Zhao, Bowen Zhao, Mei Pan, Yuanyuan Ji, Xiaohui Peng, Ran Chen. Measurement of left ventricular systolic to diastolic time index in normal fetuses in the second and third trimesters using both spectral and tissue Doppler echocardiography [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 951-958.
[9]	Danni Liu, Meng Ao, Haitao Ran, Shiyu Li, Fang Qin. Biatrial structure and function reverse remodelling in patients with persistent atrial fibrillation after cardioversion: evidence from three dimensional echocardiography and two dimensional speckle tracking imaging [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 827-835.
[10]	Jiaying Sun, Yunzhou Huang, Shutang Ren, Cuihua Wang, Xinhua Chen, Aijia Yu, Yuanlu Chen. No-invasive myocardial work for evaluation of global and segmental myocardial function in patients with left bundle branch block [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 836-843.
[11]	Jingjing Zhang, Bowen Zhao, Mei Pan, Xiaohui Peng, Yankai Mao, Chenke Pan, Lingyan Zhu, Linlin Zhu, Qiuye Lan. Evaluation of fetal pulmonary development using McGoon index measured by fetal echocardiography [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 860-865.
[12]	Lu Zhong, Sheng Cao, Hongning Song, Jinling Chen, Qing Zhou. Quality control of quantitative assessment of mitral regurgitation by echocardiography [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(07): 705-711.
[13]	Peng Xu, Jun Li, Weilun Gao, Zheng Wang, Shen Pang, Chunni Li, Ting Zhu. Application of fast rotary scanning method in fetal echocardiography [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(07): 761-766.
[14]	Shan Jin, Xueyan Ding, Qizhe Cai, Yidan Li, Zhiling Zhao, Xiheng Guo, Xiuzhang Lyu. Assessment of myocardial function in patients with obstructive sleeping apnea syndrome by left ventricular pressure-strain loop [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 575-580.
[15]	Nianyu Xue, Shengmin Zhang, Lingheng Wu, Lei Sha, Lanyue Tong, Cuiqin Shen, Zhaojun Li, Lianfang Du. Effect of serum bilirubin on myocardial function in patients with type 2 diabetes before cardiac structural changes [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 1004-1009.

Please choose a citation manager

Content to export