3D Characterization of the Aortic Valve and Aortic Arch in Bicuspid Aortic Valve Patients.

Aortic stenosis Aortopathy Bicuspid aortic valve disease Vessel segmentation

Journal

Annals of biomedical engineering
ISSN: 1573-9686
Titre abrégé: Ann Biomed Eng
Pays: United States
ID NLM: 0361512

Informations de publication

Date de publication:
11 May 2024
Historique:
received: 13 02 2024
accepted: 29 04 2024
medline: 12 5 2024
pubmed: 12 5 2024
entrez: 11 5 2024
Statut: aheadofprint

Résumé

Patients with bicuspid aortic valve (BAV) commonly have associated aortic stenosis and aortopathy. The geometry of the aortic arch and BAV is not well defined quantitatively, which makes clinical classifications subjective or reliant on limited 2D measurements. The goal of this study was to characterize the 3D geometry of the aortic arch and BAV using objective and quantitative techniques. Pre-TAVR computed tomography angiogram (CTA) in patients with BAV and aortic stenosis (AS) were analyzed (n = 59) by assessing valve commissural angle, presence of a fused region, percent of fusion, and calcium volume. The ascending aorta and aortic arch were reconstructed from patient-specific imaging segmentation to generate a centerline and calculate maximum curvature and maximum area change for the ascending aorta and the descending aorta. Aortic valve commissural angle signified a bimodal distribution suggesting tricuspid-like (≤ 150°, 52.5% of patients) and bicuspid-like (> 150°, 47.5%) morphologies. Tricuspid like was further classified by partial (10.2%) or full (42.4%) fusion, and bicuspid like was further classified into valves with fused region (27.1%) or no fused region (20.3%). Qualitatively, the aortic arch was found to have complex patient-specific variations in its 3D shape with some showing extreme diameter changes and kinks. Quantitatively, subgroups were established using maximum curvature threshold of 0.04 and maximum area change of 30% independently for the ascending and descending aorta. These findings provide insight into the geometric structure of the aortic valve and aortic arch in patients presenting with BAV and AS where 3D characterization allows for quantitative classification of these complex anatomic structures.

Identifiants

pubmed: 38734846
doi: 10.1007/s10439-024-03527-8
pii: 10.1007/s10439-024-03527-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s) under exclusive licence to Biomedical Engineering Society.

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Auteurs

Breandan B Yeats (BB)

Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.

Dahlia Galvez (D)

Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.

Sri Krishna Sivakumar (SK)

Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.

Kimberly Holst (K)

Department of Cardiovascular Surgery, Piedmont Heart Institute, Marcus Valve Center, Atlanta, GA, USA.
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA.

Venkateshwar Polsani (V)

Department of Cardiology, Piedmont Heart Institute, Marcus Valve Center, Atlanta, GA, USA.

Pradeep K Yadav (PK)

Department of Cardiology, Piedmont Heart Institute, Marcus Valve Center, Atlanta, GA, USA.

Vinod H Thourani (VH)

Department of Cardiovascular Surgery, Piedmont Heart Institute, Marcus Valve Center, Atlanta, GA, USA.

Ajit Yoganathan (A)

Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.

Lakshmi P Dasi (LP)

Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA. lakshmi.dasi@gatech.edu.

Classifications MeSH