Double S-Curve Versus Cusp-Overlap Technique
| Autor: | Hind Alosaimi, Jeremy Ben-Shoshan, Ariel Finkelstein, Michele Pighi, Pascal Thériault Lauzier, Hemal Gada, Pavel Overtchouk, Yeela Talmor-Barkan, Giuseppe Martucci, Nicolo Piazza, Marco Spaziano |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.diagnostic_test
business.industry medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences Catheter 0302 clinical medicine Valve replacement Interquartile range Aortic Valve Annulus cardiovascular system Medicine Cusp (anatomy) Fluoroscopy 030212 general & internal medicine Paravalvular leak Cardiology and Cardiovascular Medicine business Nuclear medicine Projection (set theory) |
| Zdroj: | JACC: Cardiovascular Interventions. 14:185-194 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2020.10.033 |
| Popis: | Objectives The purpose of this study was to assess the concordance between transcatheter aortic valve implantation angles generated by the “double S-curve” and “cusp-overlap” techniques. Background The “double S-curve” and “cusp-overlap” methods aim to define optimal fluoroscopic projections for transcatheter aortic valve replacement (TAVR) with a self-expandable device. Methods The study included 100 consecutive patients undergoing TAVR with self-expanding device planned by multidetector computed tomography. TAVR was performed using the double S-curve model, as a view in which both the aortic valve annulus and delivery catheter planes are displayed perpendicularly on fluoroscopy. Optimal projection according to the cusp-overlap technique was retrospectively generated by overlapping the right and left cups on the multidetector computed tomography annular plane. The angular difference between methods was assessed in spherical 3 dimensions and on the left and right anterior oblique (RAO) and cranial and caudal (CAU) axes. Results The double S-curve and cusp-overlap methods provided views located in the same quadrant, mostly the RAO and CAU, in 92% of patients with a median 3-dimensional angular difference of 10.0° (interquartile range: 5.5° to 17.9°). The 3-dimensional deviation between the average angulation obtained by each method was not statistically significant (1.49°; p = 0.349). No significant differences in average coordinates were noted between the double S-curve and cusp-overlap methods (RAO: 14.7 ± 15.2 vs. 12.9 ± 12.5; p = 0.36; and CAU: 27.0 ± 9.4 vs. 26.9 ± 10.4; p = 0.90). TAVR using the double S-curve was associated with 98% device success, low complication rate, and absence of moderate-to-severe paravalvular leak. Conclusions The double S-curve and cusp-overlap methods provide comparable TAVR projections, mostly RAO and CAU. TAVR using the double S-curve model is associated with a high rate of device success and low rate of procedural complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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