Volume 20 Issue 12
Dec.  2022
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JI Shu-jiao, LI Yu-zhen, SUN Jia, FENG Yan-fen. Evaluation of the efficacy of extracorporeal membrane oxygenation assisted transcatheter aortic valve implantation by speckle tracking[J]. Chinese Journal of General Practice, 2022, 20(12): 2025-2028. doi: 10.16766/j.cnki.issn.1674-4152.002761
Citation: JI Shu-jiao, LI Yu-zhen, SUN Jia, FENG Yan-fen. Evaluation of the efficacy of extracorporeal membrane oxygenation assisted transcatheter aortic valve implantation by speckle tracking[J]. Chinese Journal of General Practice, 2022, 20(12): 2025-2028. doi: 10.16766/j.cnki.issn.1674-4152.002761

Evaluation of the efficacy of extracorporeal membrane oxygenation assisted transcatheter aortic valve implantation by speckle tracking

doi: 10.16766/j.cnki.issn.1674-4152.002761
Funds:

 2018020540

  • Received Date: 2021-07-29
    Available Online: 2023-02-07
  •   Objective  To investigate the application value of tissue mitral annular displacement (TMAD) speckle tracking technique in extracorporeal membrane oxygenation (ECMO) assisted transcatheter aortic valve implantation (TAVI) in the treatment of severe aortic stenosis (AS).  Methods  A total of 16 patients with severe AS with left ventricular ejection fraction (LVEF) < 25% underwent ECMO assisted TAVI in Henan Provincial Chest Hospital from September 2019 to March 2021 were retrospectively analyzed. The changes of speckle tracking parameters [tissue motion tracking of mitral annular average displacement (TMADmid), tissue motion tracking of mitral annular average displacement rate (TMADmid%), global longitudinal strain (GLS)] and conventional echocardiographic parameters [LVEF, left ventricular diastolic end diameter (LVEDd), stroke volume (SV)] were statistically analyzed before TAVI treatment, immediately after ECMO removal and 1 month after operation. The evaluation value of speckled tracking technique in the postoperative efficacy of ECMO assisted TAVI was analyzed.  Results  The TMADmid [(3.2±1.3) mm, (6.9±1.3) mm, (11.2±2.5) mm], TMADmid% [(3.5±2.6) %, (7.0±3.8) %, (10.1±2.1) %] and GLS [(5.9±3.5) %, (8.9±2.7) %, (13.2±3.9) %] increased gradually before TAVI treatment, immediately after ECMO removal and 1 month after operation, and the differences were statistically significant (all P < 0.05). One month after operation, LVEF [(42.2±5.3) %] was significantly higher than that before operation [(22.2±5.5) %] and immediately after ECMO removal [(23.8±2.5) %, P < 0.05]. Compared with pre-operation, LVEF increased immediately after ECMO removal, with no significant difference (P>0.05). The TMADmid and TMADmid% were positively correlated with GLS (r=0.499, 0.586, all P < 0.05).  Conclusion  The tissue mitral annular displacement speckle tracking technique can be used as a sensitive reference index to evaluate the diagnosis and treatment effect of TAVI in patients with AS. The ECMO assisted TAVI is safe and effective in the treatment of severe AS.

     

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