1. Dynamic Annular Modeling of the Unrepaired Complete Atrioventricular Canal Annulus
- Author
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John M. Simpson, Jing Huang, Christian Herz, Hannah H. Nam, Gabor Fichtinger, Patrick V. Dinh, Alison M. Pouch, Meryl S. Cohen, Andras Lasso, Ahmed H. Aly, Saleha Kabir, Andrew C. Glatz, Adriana Posada, David M. Harrild, Matthew A. Jolley, and Gerald R. Marx
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Echocardiography, Three-Dimensional ,Regurgitation (circulation) ,Article ,Mitral valve ,Humans ,Medicine ,Mitral Valve Annulus ,cardiovascular diseases ,Cardiac Surgical Procedures ,Retrospective Studies ,Annulus (mycology) ,Atrioventricular valve ,Cardiac cycle ,business.industry ,Heart Septal Defects ,Infant ,Anatomy ,equipment and supplies ,medicine.disease ,medicine.anatomical_structure ,Child, Preschool ,cardiovascular system ,Atrioventricular canal ,Female ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Mitral valve regurgitation ,Echocardiography, Transesophageal - Abstract
BACKGROUND: Repair of complete atrioventricular canal (CAVC) is often complicated by atrioventricular valve regurgitation, particularly of the left-sided valve. Understanding the three-dimensional (3D) structure of the atrioventricular canal annulus prior to repair may help to inform optimized repair. However, the 3D shape and movement of the CAVC annulus has yet to be quantified nor has it been rigorously compared to a normal mitral valve annulus. METHODS: The complete annuli of 43 patients with CAVC were modeled in 4 cardiac phases using transthoracic 3D echocardiograms and custom code. The annular structure was compared to the annuli of 20 normal pediatric mitral valves using 3D metrics and statistical shape analysis (Procrustes analysis). RESULTS: The unrepaired CAVC annulus varied in shape significantly throughout the cardiac cycle. Procrustes analysis visually demonstrated that the average normalized CAVC annular shape is more planar than the normal mitral annulus. Quantitatively, the annular height to valve width ratio of the native left CAVC atrioventricular valve was significantly lower than that of a normal mitral valve in all systolic phases(p
- Published
- 2022