Bicuspid Aortic Valve Anatomy and Relationship With Devices: The BAVARD Multicenter Registry.

Autor:	Tchetche D; Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France (D.T., C.d.B., R.P., J.M.-M.d.N., N.D.)., de Biase C; Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France (D.T., C.d.B., R.P., J.M.-M.d.N., N.D.)., van Gils L; Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands (L.v.G., N.M.V.M.)., Parma R; Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France (D.T., C.d.B., R.P., J.M.-M.d.N., N.D.)., Ochala A; 3rd Department of Cardiology, Medical University of Silesia, Katowice, Poland (R.P., A.O.)., Lefevre T; Institut cardiovasculaire Paris sud, Hôspital prive Jacques Cartier, Massy, France (T.L., T.H.)., Hovasse T; Institut cardiovasculaire Paris sud, Hôspital prive Jacques Cartier, Massy, France (T.L., T.H.)., De Backer O; The Heart Center-Rigshospitalet, Copenhagen, Denmark (O.D.B., L.S.)., Sondergaard L; The Heart Center-Rigshospitalet, Copenhagen, Denmark (O.D.B., L.S.)., Bleiziffer S; German Heart Center, Munich (S.B., R.L.)., Lange R; German Heart Center, Munich (S.B., R.L.)., Kornowski R; Cardiology Department, Rabin Medical Center, Petach Tikva, Tel-Aviv University, Israel (R.K., U.L.)., Landes U; Cardiology Department, Rabin Medical Center, Petach Tikva, Tel-Aviv University, Israel (R.K., U.L.)., Norgaard BL; Department Cardiology, Aarhus University Hospital, Denmark (B.L.N.)., Biasco L; Centro Cardiotoracico TICINO, Lugano, Switzerland (L.B.)., Philippart R; 3rd Department of Cardiology, Medical University of Silesia, Katowice, Poland (R.P., A.O.)., Molina-Martin de Nicolas J; Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France (D.T., C.d.B., R.P., J.M.-M.d.N., N.D.)., Mylotte D; Department of Cardiology, University Hospital Galway, Ireland (D.M.)., Lemee C; Independent biostatistician, Toulouse, France (C.L.)., Dumonteil N; Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France (D.T., C.d.B., R.P., J.M.-M.d.N., N.D.)., Van Mieghem NM; Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands (L.v.G., N.M.V.M.).
Jazyk:	angličtina
Zdroj:	Circulation. Cardiovascular interventions [Circ Cardiovasc Interv] 2019 Jan; Vol. 12 (1), pp. e007107.
DOI:	10.1161/CIRCINTERVENTIONS.118.007107
Abstrakt:	Background: Sizing for transcatheter aortic valve implantation in bicuspid aortic valves (BAV) remains controversial. Methods and Results: The aim of the BAVARD (Bicuspid Aortic Valve Anatomy and Relationship With Devices) retrospective registry is to capture the sizing ratios used for transcatheter aortic valve implantation in BAV and analyze the second-generation prostheses geometry postimplantation. About 101 patients with BAV along with available pre- and post-transcatheter aortic valve implantation multidetector computed tomography were compared with 88 tricuspid aortic valves (TAV) patients. Preprocedural multidetector computed tomography diagnosed type 0 and type 1 BAV in, respectively, 12.9% and 86.1 % of BAV. At baseline, the ellipticity index was similar between BAV and TAV patients: 1.2±0.1 versus 1.2±0.1, P=0.09. The mean annular oversizing was, respectively, 1.14±0.04 and 1.04±0.04, P<0.001, in TAV and BAV patients. The mean prosthesis intercommissural distance, ratio was 1.03±0.1. The mean diameter of the prostheses at the annulus matched the mean perimeter-derived diameter of the aortic annulus at baseline with TAV (23.3±2.2 versus 23.6±1.9, P=0.4) and was smaller with BAV (24±2.8 versus 26.8±3.1, P<0.01), confirming 11% underexpansion in BAV. Finally, in situ, prosthesis diameter and ellipticity followed the same pattern, with stable values from the distal edge to 12 mm above, in both groups. Conclusions: Second-generation prostheses similarly reshape the aortic annulus in TAV and BAV. Prostheses keep consistent diameters from distal edge to 12 mm in TAV and BAV. Prosthesis underexpansion is constantly observed in BAV. Annular-based sizing is accurate in BAV with minimal oversizing. The intercommissural distance, 4 mm above the annulus, could be integrated in gray zones. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03495050.
Databáze:	MEDLINE
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