Association of aortic valve calcification severity with the degree of aortic regurgitation after transcatheter aortic valve implantation

被引:142
作者
Koos, Ralf [1 ]
Mahnken, Andreas Horst [2 ]
Dohmen, Guido [3 ]
Brehmer, Kathrin [1 ]
Guenther, Rolf W. [2 ]
Autschbach, Ruediger [3 ]
Marx, Nikolaus [1 ]
Hoffmann, Rainer [1 ]
机构
[1] Rhein Westfal TH Aachen, Univ Hosp RWTH Aachen, Dept Cardiol, D-52074 Aachen, Germany
[2] Rhein Westfal TH Aachen, Univ Hosp RWTH Aachen, Dept Diagnost Radiol, D-52074 Aachen, Germany
[3] Rhein Westfal TH Aachen, Univ Hosp RWTH Aachen, Dept Cardiac Surg, D-52074 Aachen, Germany
关键词
Calcification; Aortic valve regurgitation; Aortic valve implantation; Computed tomography; REPLACEMENT; PROSTHESIS; STENOSIS; PREDICTORS;
D O I
10.1016/j.ijcard.2010.03.004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: This study sought to examine a possible relationship between the severity of aortic valve calcification (AVC), the distribution of AVC and the degree of aortic valve regurgitation (AR) after transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS). Methods: 57 patients (22men, 81 +/- 5 years) with symptomatic AS and with a logistic EuroSCORE of 24 +/- 12 were included. 38 patients (67%) received a third (18F)-generation CoreValve (R) aortic valve prosthesis, in 19 patients (33%) an Edwards SAPIEN (TM) prosthesis was implanted. Prior to TAVI dual-source computed tomography for assessment of AVC was performed. To determine the distribution of AVC the percentage of the calcium load of the most severely calcified cusp was calculated. After TAVI the degree of AR was determined by angiography and echocardiography. The severity of AR after TAVI was related to the severity and distribution of AVC. Results: There was no association between the distribution of AVC and the degree of paravalvular AR after TAVI as assessed by angiography (r=-0.02, p=0.88). Agatston AVC scores were significantly higher in patients with AR grade >= 3 (5055 +/- 1753, n=3) than in patients with AR grade < 3 (1723 +/- 967, p=0.03, n=54). Agatston AVC scores>3000 were associated with a relevant paravalvular AR and showed a trend for increased need for second manoeuvres. There was a significant correlation between the severity of AVC and the degree of AR after AVR (r=0.50, p<0.001). Conclusion: Patients with severe AVC have an increased risk for a relevant AR after TAVI as well as a trend for increased need for additional procedures. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:142 / 145
页数:4
相关论文
共 20 条
[1]   QUANTIFICATION OF CORONARY-ARTERY CALCIUM USING ULTRAFAST COMPUTED-TOMOGRAPHY [J].
AGATSTON, AS ;
JANOWITZ, WR ;
HILDNER, FJ ;
ZUSMER, NR ;
VIAMONTE, M ;
DETRANO, R .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1990, 15 (04) :827-832
[2]   The potential of myocardial perfusion scintigraphy for risk stratification of asymptomatic patients with type 2 diabetes [J].
Bax, Jeroen J. ;
Bonow, Robert O. ;
Tschoepe, Diethelm ;
Inzucchi, Silvio E. ;
Barrett, Eugene .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2006, 48 (04) :754-760
[3]   Results of percutaneous and transapical transcatheter aortic valve implantation performed by a surgical team [J].
Bleiziffer, Sabine ;
Ruge, Hendrik ;
Mazzitelli, Domenico ;
Schreiber, Christian ;
Hutter, Andrea ;
Laborde, Jean-Claude ;
Bauernschmitt, Robert ;
Lange, Ruediger .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2009, 35 (04) :615-621
[4]   Ethical authorship and publishing [J].
Coats, Andrew J. S. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2009, 131 (02) :149-150
[5]   Treatment of calcific aortic stenosis with the percutaneous heart valve - Mid-term follow-up from the initial feasibility studies: The French experience [J].
Cribier, A ;
Eltchaninoff, H ;
Tron, C ;
Bauer, F ;
Agatiello, C ;
Nercolini, D ;
Tapiero, S ;
Litzler, PY ;
Bessou, JP ;
Babaliaros, V .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2006, 47 (06) :1214-1223
[6]   Echocardiographic predictors of left ventricular functional recovery following valve replacement surgery for severe aortic stenosis [J].
Ding, Wen-hong ;
Lam, Yat-yin ;
Kaya, Mehmet G. ;
Li, Wei ;
Chung, Robin ;
Pepper, John R. ;
Henein, Michael Y. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2008, 128 (02) :178-184
[7]   Predictors of survival after aortic valve replacement in patients with low-flow and high-gradient aortic stenosis [J].
Ding, Wen-Hong ;
Lam, Yat-Yin ;
Duncan, Alison ;
Li, Wei ;
Lim, Eric ;
Kaya, Mehmet G. ;
Chung, Robin ;
Pepper, John R. ;
Henein, Michael Y. .
EUROPEAN JOURNAL OF HEART FAILURE, 2009, 11 (09) :897-902
[8]   First report on a human percutaneous transluminal implantation of a self-expanding valve prosthesis for interventional treatment of aortic valve [J].
Grube, E ;
Laborde, JC ;
Zickmann, B ;
Gerckens, U ;
Felderhoff, T ;
Sauren, B ;
Bootsveld, A ;
Buellesfeld, L ;
Iversen, S .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2005, 66 (04) :465-469
[9]   Percutaneous aortic valve replacement for severe aortic stenosis in high-rick patients using the second- and current third-generation self-expanding CoreValve prosthesis - Device success and 30-day clinical outcome [J].
Grube, Eberhard ;
Schuler, Gerhard ;
Buellesfeld, Lutz ;
Gerckens, Ulrich ;
Linke, Axel ;
Wenaweser, Peter ;
Sauren, Barthel ;
Mohr, Friedrich-Wilhelm ;
Walther, Thomas ;
Zickmann, Bernfried ;
Iversen, Stein ;
Felderhoff, Thomas ;
Cartier, Raymond ;
Bonan, Raoul .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 50 (01) :69-76
[10]   Percutaneous implantation of the CoreValve self-expanding valve prosthesis in high-risk patients with aortic valve disease - The Siegburg First-in-Man Study [J].
Grube, Eberhard ;
Laborde, Jean C. ;
Gerckens, Ulrich ;
Felderhoff, Thomas ;
Sauren, Barthel ;
Buellesfeld, Lutz ;
Mueller, Ralf ;
Menichelli, Maurizio ;
Schmidt, Thomas ;
Zickmann, Bernfried ;
Iversen, Stein ;
Stone, Gregg W. .
CIRCULATION, 2006, 114 (15) :1616-1624