共 22 条
Computed tomography-based evaluation of aortic annulus, prosthesis size and impact on early residual aortic regurgitation after transcatheter aortic valve implantation
被引:54
作者:

Buzzatti, Nicola
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机构:
Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy

Maisano, Francesco
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Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy

Latib, Azeem
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机构:
Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy

Cioni, Micaela
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机构:
Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy

Taramasso, Maurizio
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Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy

Mussardo, Marco
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Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy

Colombo, Antonio
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机构:
Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy

Alfieri, Ottavio
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机构:
Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy
机构:
[1] Hosp San Raffaele, Dept Cardiac Surg, I-20132 Milan, Italy
关键词:
TAVI;
MDCT;
Residual;
Paravalvular;
Aortic;
Regurgitation;
PARAVALVULAR REGURGITATION;
COREVALVE PROSTHESIS;
STENOSIS;
REPLACEMENT;
D O I:
10.1093/ejcts/ezs155
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Computed tomography (CT) is an increasingly utilized method for the evaluation of patient suitability for transcatheter aortic valve implantation (TAVI). The aim of this study was to analyse the role of CT in the choice of prosthesis and the prevention of residual aortic regurgitation (RAR). From November 2007 to September 2010, 115 patients (median age 81 years, inter-quantile range (IQR) 76-85; median ejection fraction 55%, IQR 45-60; median logistic EuroSCORE 19.7, IQR 11.0-32.1) undergoing TAVI were evaluated with a pre-procedural CT. An aortic complex was evaluated with multi-planar reconstructions, and we defined significant early RAR as RAR >= 2, and prosthesis/annulus mismatch (PAM) as the ratio between prosthesis size and mean annular size. All analyses were conducted for the whole sample and then separately for the two types of prosthesis implanted. An Edwards-SAPIEN((R)) prosthesis was implanted in 62 patients (54.7%), and a Medtronic CoreValve((R)) in 52 (45.2%). Aortic annulus minimum and maximum diameters were 22.6 +/- 2.1 and 26.0 +/- 2.3 mm, respectively. The aortic annulus diameter and the length of the free edge of the aortic cusps were linearly related to a 1:1 ratio (P < 0.0001). Significant RAR (34 patients, 30%) appeared directly related to the annulus diameters (particularly maximum and medium diameters, P = 0.0003 and P = 0.0010, respectively) and cusp length (P = 0.0007) but inversely correlated with PAM (P = 0.0006). Prosthesis/annulus oversizing was associated with a reduction in RAR, with a cut-off of 7% as the limit below which RAR increases; moreover, we observed different cut-off values for the Edwards and CoreValve prostheses, although statistical significance was not reached for the CoreValve (respectively, 2% with P < 0.0001, 11% with P = 0.16). No association was found between PAM and possible PAM-related complications. CT evaluation prior to TAVI showed that RAR was directly correlated with aortic root dimensions (particularly maximum and medium annulus diameters and cusp lengths) and inversely correlated with PAM. Oversizing the prosthesis by at least 7% reduces the risk of RAR. CT is an essential and invaluable tool in the assessment of patients undergoing TAVI.
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页码:43 / 51
页数:9
相关论文
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Rhein Westfal TH Aachen, Univ Hosp RWTH Aachen, Dept Cardiac Surg, D-52074 Aachen, Germany Rhein Westfal TH Aachen, Univ Hosp RWTH Aachen, Dept Cardiol, D-52074 Aachen, Germany

Marx, Nikolaus
论文数: 0 引用数: 0
h-index: 0
机构:
Rhein Westfal TH Aachen, Univ Hosp RWTH Aachen, Dept Cardiol, D-52074 Aachen, Germany Rhein Westfal TH Aachen, Univ Hosp RWTH Aachen, Dept Cardiol, D-52074 Aachen, Germany

Hoffmann, Rainer
论文数: 0 引用数: 0
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机构:
Rhein Westfal TH Aachen, Univ Hosp RWTH Aachen, Dept Cardiol, D-52074 Aachen, Germany Rhein Westfal TH Aachen, Univ Hosp RWTH Aachen, Dept Cardiol, D-52074 Aachen, Germany
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FATAL AORTIC RUPTURE DURING PERCUTANEOUS BALLOON VALVULOPLASTY FOR VALVULAR AORTIC-STENOSIS
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LEMBO, NJ
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ROUBIN, GS
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HAMMAMI, A
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NIEDERMAN, AL
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AMERICAN JOURNAL OF CARDIOLOGY,
1987, 60 (08)
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LEMBO, NJ
论文数: 0 引用数: 0
h-index: 0
机构: EMORY UNIV HOSP,SCH MED,DEPT RADIOL,ATLANTA,GA 30322

KING, SB
论文数: 0 引用数: 0
h-index: 0
机构: EMORY UNIV HOSP,SCH MED,DEPT RADIOL,ATLANTA,GA 30322

ROUBIN, GS
论文数: 0 引用数: 0
h-index: 0
机构: EMORY UNIV HOSP,SCH MED,DEPT RADIOL,ATLANTA,GA 30322

HAMMAMI, A
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机构: EMORY UNIV HOSP,SCH MED,DEPT RADIOL,ATLANTA,GA 30322

NIEDERMAN, AL
论文数: 0 引用数: 0
h-index: 0
机构: EMORY UNIV HOSP,SCH MED,DEPT RADIOL,ATLANTA,GA 30322
[10]
In-Hospital Complications After Transcatheter Aortic Valve Implantation Revisited According to the Valve Academic Research Consortium Definitions
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Nuis, Rutger-Jan
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Otten, Amber M.
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Tzikas, Apostolos
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Schultz, Carl J.
;
van der Boon, Robert
;
van Geuns, Robert-Jan
;
van Domburg, Ron T.
;
Koudstaal, Peter J.
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Kappetein, Arie Pieter
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Serruys, Patrick W.
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de Jaegere, Peter P.
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CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS,
2011, 78 (03)
:457-467

Nuis, Rutger-Jan
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机构:
Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

Piazza, Nicolo
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Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

Van Mieghem, Nicolas M.
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Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

Otten, Amber M.
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Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

Tzikas, Apostolos
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机构:
Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

Schultz, Carl J.
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h-index: 0
机构:
Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

van der Boon, Robert
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Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

van Geuns, Robert-Jan
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Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

van Domburg, Ron T.
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机构:
Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

Koudstaal, Peter J.
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h-index: 0
机构:
Erasmus MC, Dept Neurol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

Kappetein, Arie Pieter
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h-index: 0
机构:
Erasmus MC, Dept Cardiothorac Surg, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

Serruys, Patrick W.
论文数: 0 引用数: 0
h-index: 0
机构:
Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

de Jaegere, Peter P.
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h-index: 0
机构:
Erasmus MC, Dept Cardiol, Rotterdam, Netherlands Erasmus MC, Dept Cardiol, Rotterdam, Netherlands