TY - JOUR
T1 - Imaging surveillance after open aortic repair
T2 - A feasibility study of three-dimensional growth mapping
AU - Ahmed, Yunus
AU - Nama, Nitesh
AU - Houben, Ignas B.
AU - Van Herwaarden, Joost A.
AU - Moll, Frans L.
AU - Williams, David M.
AU - Figueroa, C. Alberto
AU - Patel, Himanshu J.
AU - Burris, Nicholas S.
N1 - Funding Information:
Nitesh Nama: American Heart Association Fellowship (AHA 20POST35220004). C. Alberto Figueroa: Edward B. Diethrich Professorship; the Bob and Ann Aikens Aortic Grants Program and the Frankel Cardiovascular Center. Himanshu J. Patel: Joe D. Morris Professorship; David Hamilton Fund and the Phil Jenkins Breakthrough Fund. Nicholas S. Burris: Radiologic Society of North America Research Scholar Grant (RSCH 1801) and National Institutes of Health (R44 HL145953).
Publisher Copyright:
© 2021 The Author(s). Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Objectives: Confident growth assessment during imaging follow-up is often limited by substantial variability of diameter measurements and the fact that growth does not always occur at standard measurement locations. There is a need for imaging-based techniques to more accurately assess growth. In this study, we investigated the feasibility of a three-dimensional aortic growth assessment technique to quantify aortic growth in patients following open aortic repair. Methods: Three-dimensional aortic growth was measured using vascular deformation mapping (VDM), a technique which quantifies the localized rate of volumetric growth at the aortic wall, expressed in units of Jacobian (J) per year. We included 16 patients and analysed 6 aortic segments per patient (96 total segments). Growth was assessed by 3 metrics: clinically reported diameters, Jacobian determinant and targeted diameter re-measurements. Results: VDM was able to clearly depict the presence or absence of localized aortic growth and allows for an assessment of the distribution of growth and its relation to anatomic landmarks (e.g. anastomoses, branch arteries). Targeted diameter change showed a stronger and significant correlation with J (r = 0.20, P = 0.047) compared to clinical diameter change (r = 0.15, P = 0.141). Among 20/96 (21%) segments with growth identified by VDM, growth was confirmed by clinical measurements in 7 and targeted re-measurements in 11. Agreement of growth assessments between VDM and diameter measurements was slightly higher for targeted re-measurements (kappa = 0.38) compared to clinical measurements (kappa = 0.25). Conclusions: Aortic growth is often uncertain and underappreciated when assessed via standard diameter measurements. Three-dimensional growth assessment with VDM offers a more comprehensive assessment of growth, allows for targeted diameter measurements and could be an additional tool to determine which post-surgical patients at high and low risk for future complications.
AB - Objectives: Confident growth assessment during imaging follow-up is often limited by substantial variability of diameter measurements and the fact that growth does not always occur at standard measurement locations. There is a need for imaging-based techniques to more accurately assess growth. In this study, we investigated the feasibility of a three-dimensional aortic growth assessment technique to quantify aortic growth in patients following open aortic repair. Methods: Three-dimensional aortic growth was measured using vascular deformation mapping (VDM), a technique which quantifies the localized rate of volumetric growth at the aortic wall, expressed in units of Jacobian (J) per year. We included 16 patients and analysed 6 aortic segments per patient (96 total segments). Growth was assessed by 3 metrics: clinically reported diameters, Jacobian determinant and targeted diameter re-measurements. Results: VDM was able to clearly depict the presence or absence of localized aortic growth and allows for an assessment of the distribution of growth and its relation to anatomic landmarks (e.g. anastomoses, branch arteries). Targeted diameter change showed a stronger and significant correlation with J (r = 0.20, P = 0.047) compared to clinical diameter change (r = 0.15, P = 0.141). Among 20/96 (21%) segments with growth identified by VDM, growth was confirmed by clinical measurements in 7 and targeted re-measurements in 11. Agreement of growth assessments between VDM and diameter measurements was slightly higher for targeted re-measurements (kappa = 0.38) compared to clinical measurements (kappa = 0.25). Conclusions: Aortic growth is often uncertain and underappreciated when assessed via standard diameter measurements. Three-dimensional growth assessment with VDM offers a more comprehensive assessment of growth, allows for targeted diameter measurements and could be an additional tool to determine which post-surgical patients at high and low risk for future complications.
KW - Aortic growth
KW - Imaging surveillance
KW - Open aortic aneurysm repair
KW - Thoracic aortic aneurysm
KW - Vascular deformation mapping
UR - http://www.scopus.com/inward/record.url?scp=85116600745&partnerID=8YFLogxK
U2 - 10.1093/ejcts/ezab142
DO - 10.1093/ejcts/ezab142
M3 - Article
C2 - 33779717
AN - SCOPUS:85116600745
SN - 1010-7940
VL - 60
SP - 651
EP - 659
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
IS - 3
ER -