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DYNAMIC AORTIC ROOT MEASUREMENTS USING CT ANGIOGRAPHY
Leon Vink
10189912
University of Amsterdam
Wetenschappelijke samenvatting
During CTA imaging the heart is moving due to the contraction of the heart. This might
influence the CTA scan images that will be used to plan transcatheter aortic valve implantation
(TAVI). Using these images, the size of the prosthesis, the chance for patients to encounter
Paravalvular regurgitation after TAVI and the suitability of the access routes are checked.
In this study, the area and the cross-sectional diameters of the aortic annulus and the
calcium volume in the aortic root are determined during 10 heart phases of the cardiac cycle to
determine whether there is a specific phase to quantify these factors for TAVI. Does the
movement influence these factors? Also the difference in area variation in low- and high
calcium patients is quantified to determine whether the amount of calcium volume influences
the area variation over the heart phases.
3mensio provides the tools to analyze these factors during 10 heart phases. After
defining the aortic annulus plane, for every phase the area, the cross-sectional diameters and
are determined manually and the variation and its normalization are calculated. Using the
related samples Wilcoxon signed rank test, the significant difference between the area
variations of two heart phases are determined. The calcium volume is calculated by 3mensio in
a volume of interest enclosing the aortic annulus and the variation and its normalization are
calculated. For determining if the amount calcium volume influences the area variation, the
patient group is divided into a low- and high calcium volume group.
There are 13 significant differences between heart phases of the area variation. The
results for the calcium volume variation and the cross-sectional diameters variation do not
show specific phase to quantify them. And also calcium volume measurements do not show a
trend. The area variation in high calcium volume patients is twice as high as in low calcium
volume patients.
The amount of calcium volume and the movement of the heart due to contraction do
influence the area variation. However, it differs per patients whether this patient has large
difference in area variation in the aortic annulus and calcium volume in the aortic root. Based
on the results, there is no specific heart phase to quantify the cross-sectional diameters in the
aortic annulus and the calcium volume in the aortic root.