Correlation between fluoroscopy and tomographic aortic-root measurements in the decision of the transcatheter heart valve size in patients undergoing transcatheter aortic valve implantation

Autor:	Michael Joner, Erion Xhepa, Tobias Rheude, N P Mayr, Jonathan M Michel, Costanza Pellegrini, G Borrayo-Sanchez, A M Kasel, Hector A. Alvarez-Covarrubias
Rok vydání:	2021
Předmět:	medicine.medical_specialty medicine.diagnostic_test Transcatheter aortic business.industry Aortic root medicine.anatomical_structure Internal medicine medicine Cardiology Fluoroscopy In patient Heart valve Cardiology and Cardiovascular Medicine business
Zdroj:	European Heart Journal. 42
ISSN:	1522-9645 0195-668X
DOI:	10.1093/eurheartj/ehab724.1658
Popis:	Introduction and hypothesis Transcatheter aortic valve implantation (TAVI) has become the standard treatment in intermediate and high-risk patients with high degree aortic stenosis (AS).(1–2) These has been also extended to low-risk and younger patients.(3–5) Besides the use of computed-tomography (CT) as diagnostic method to measure the aortic anatomy for transcatheter heart valve (THV) size decision and the radiation exposure (RE) during TAVI, younger patients are more exposed to radiation and contrast media (CM) complications due to a potentially second procedure.(6) Reducing RE and CM using only angiography aortic measurement could reduce the risk of RE and CM related complications without compromising the efficacy of the THV. We hypothesize that angiographic aortic root (AR) measure has good correlation with CT measure without compromising safety and efficacy of the THV. Methods Observational analysis: 1250 transfemoral TAVI patients with balloon or self-expandable valves were included. Aortic root CT measurement was done in all patients. AR measurement using Follow the right cup rule (7) was additionally done in 505 patients. Correlation between CT only (Group I n=745) versus CT and AR measurement (Group II n=505) was done. An inter and intraobserver validation analysis was done. Primary endpoint was VARC-2 device success. Secondary safety endpoints were composite of in-hospital and 30-days complications. Results Really good intra (0.86, p Conclusions Compared to CT, AR measurement is a good option selecting THV size. No differences regarding device success and in-hospital and 30 days follow-up complications were observed. AR measurement could replace CT in specific cases. Funding Acknowledgement Type of funding sources: None. Angiographic and CT measurementsEndpoints
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::cf7bff8b418f17ce3e6ee66f14ab23e5 https://doi.org/10.1093/eurheartj/ehab724.1658 Zobrazit plný text záznamu