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Belvroy VM, Zubair MM, van Herwaarden JA, et al. Important longitudinal and circumferential pulsatile changes in zone 0 of the aorta during the cardiac cycle. Eur J Cardiothorac Surg. 2020;doi: 10.1093/ejcts/ezaa306.
Belvroy, V. M., Zubair, M. M., van Herwaarden, J. A., Trimarchi, S., Moll, F. L., & Bismuth, J. (2020). Important longitudinal and circumferential pulsatile changes in zone 0 of the aorta during the cardiac cycle. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, . https://doi.org/10.1093/ejcts/ezaa306
Belvroy, Viony M, et al. "Important longitudinal and circumferential pulsatile changes in zone 0 of the aorta during the cardiac cycle." European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery vol. (2020). doi: https://doi.org/10.1093/ejcts/ezaa306
Belvroy VM, Zubair MM, van Herwaarden JA, Trimarchi S, Moll FL, Bismuth J. Important longitudinal and circumferential pulsatile changes in zone 0 of the aorta during the cardiac cycle. Eur J Cardiothorac Surg. 2020 Oct 01; doi: 10.1093/ejcts/ezaa306. Epub 2020 Oct 01. PMID: 33001164.
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Eur J Cardiothorac Surg. 2020 Oct 01; doi: 10.1093/ejcts/ezaa306. Epub 2020 Oct 01.

Important longitudinal and circumferential pulsatile changes in zone 0 of the aorta during the cardiac cycle.

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

Viony M Belvroy, M Mujeeb Zubair, Joost A van Herwaarden, Santi Trimarchi, Frans L Moll, Jean Bismuth

Affiliations

  1. Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA.
  2. Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, Netherlands.
  3. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy.
  4. Department of Clinical and Community Sciences, University of Milan, Milan, Italy.

PMID: 33001164 DOI: 10.1093/ejcts/ezaa306

Abstract

OBJECTIVES: Correct stent-graft sizing is important when planning for thoracic endovascular repair in zone 0. As the movements of the aorta are constantly evolving in longitudinal and circumferential directions during the cardiac cycle, the diameter may not be the only important measurement. The aim of this study is to measure the circumferential and longitudinal pulsatile changes throughout the cardiac cycle.

METHODS: Ninety-two patients, who were evaluated for transcatheter aortic valve replacement, were selected for this retrospective study. Their electrocardiogram-gated cardiac computed tomography was analysed. We identified the area, perimeter and diameter of the thoracic aorta in zone 0 and calculated the differences between these parameters at 3 locations in zone 0. The measurements were made in multiplanar views perpendicular to the semi-automatically created centreline in both systolic and diastolic phases.

RESULTS: The mean age of our study cohort was 77 ± 11 years. The mean change between systole and diastole of the area (mm2), perimeter (mm) and diameter (mm) were compared at 3 different locations in the ascending aorta: at the sinotubular junction (0.78 mm2 vs 0.89 mm vs 1.41 mm), mid-ascending (0.72 mm2 vs 0.68 vs 0.81 mm) and proximal edge of the brachiocephalic artery (0.76 mm2 vs 0.73 mm vs 0.73 mm). The change in percentage is the smallest in the area at the sinotubular junction compared to the perimeter and diameter (2.6% vs 3.1% vs 4.7%).

CONCLUSIONS: Changes in measurement of ascending aortic diameter with cardiac cycle are larger than measurement change in the area. This is especially more pronounced in zone 0A. For more accurate information on the morphometric changes, it may be necessary to measure the area when planning for thoracic endovascular repair to maximize results. A prospective study comparing these different measurements regarding the outcomes is advised by the authors to understand the clinical implications.

© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Keywords: Ascending aorta; Cardiac motion; Thoracic endovascular aortic repair

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