Association of individual aortic leaflet calcification on paravalvular regurgitation and conduction abnormalities with self-expanding trans-catheter aortic valve insertion
| Autor: | Edward D. Nicol, Saeed Mirsadraee, Allan Davies, Vasileios F. Panoulas, Alessia Gambaro, Ana Luisa Costa, Alison Duncan, Ciara Mahon, Simon J. Davies, Francesca Musella |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Aortic valve
medicine.medical_specialty medicine.medical_treatment 0299 Other Physical Sciences 0205 Optical Physics 0204 Condensed Matter Physics Regurgitation (circulation) 030204 cardiovascular system & hematology Balloon 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Radiology Nuclear Medicine and imaging 030212 general & internal medicine Trans-catheter aortic valve implantation (TAVI) paravalvular aortic regurgitation (PVR) Science & Technology business.industry Radiology Nuclear Medicine & Medical Imaging medicine.disease Aortic valvuloplasty Stenosis Catheter medicine.anatomical_structure permanent pacemaker insertion Cardiology cardiovascular system Original Article Complication business Life Sciences & Biomedicine Calcification |
| Zdroj: | Quant Imaging Med Surg |
| Popis: | Background Complication rates of paravalvular aortic regurgitation (PVR) and permanent pacemaker insertion remain high in patients undergoing trans-catheter aortic valve insertion for severe aortic stenosis. The spatial distribution of calcium between individual aortic valve leaflets, and its potential role in these complications is gaining interest. We aimed to assess the accuracy of individual aortic valve leaflet calcium quantification, and to determine its effect on the frequency of these complications. Methods This was a retrospective study of 251 patients who underwent trans-catheter aortic valve insertion using the Evolut RTM valve. The off-line Terarecon software platform was used for Agatston scoring the short axis views. Results There was a correlation between the sum of the individual leaflet and the total aortic valve calcium score. There was a univariate association between an increase [per 100 Agatston unit (AU)] in both right coronary leaflet (RCL) and left coronary leaflet (LCL) calcium with the risk of PVR. There was an association between an increase in LCL calcium score (per 100 AU) and need for post-implantation balloon aortic valvuloplasty (BAV). There was no association between individual leaflet calcification on the risk of permanent pacemaker insertion. Conclusions This study supports the idea that a quantifiable and reproducible method of individual valve leaflet calcification score may serve as an independent risk factor for paravalvular regurgitation, beyond visual assessment of asymmetry. However, the same may not be true of spatial calcium distribution and permanent pacemaker implantation (PPI). |
| Databáze: | OpenAIRE |
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