Differences in clinical valve size selection and valve size selection for patient-specific computer simulation in transcatheter aortic valve replacement (TAVR): a retrospective multicenter analysis

Autor: Nahid El Faquir, Peter de Jaegere, Peter Mortier, Giorgia Rocatello, Zouhair Rahhab, Nicolas M. Van Mieghem, Ole De Backer, Johan Bosmans
Přispěvatelé: Cardiology
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Patient-Specific Modeling
Health Knowledge
Attitudes
Practice
medicine.medical_treatment
030204 cardiovascular system & hematology
0302 clinical medicine
Valve replacement
Retrospective analysis
030212 general & internal medicine
Cardiac imaging
Aged
80 and over
Observer Variation
Models
Cardiovascular
Patient specific
Computer simulation
Aortic Valve
Heart Valve Prosthesis
Cohort
Cardiology
Radiographic Image Interpretation
Computer-Assisted
Female
Clinical Competence
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Transcatheter aortic
Concordance
Clinical Decision-Making
TAVR
Prosthesis Design
Transcatheter Aortic Valve Replacement
03 medical and health sciences
Predictive Value of Tests
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Selection (genetic algorithm)
Aged
Retrospective Studies
Computer. Automation
Surgeons
Original Paper
business.industry
Aortic stenosis
Patient Selection
Reproducibility of Results
Aortic Valve Stenosis
Human medicine
business
Tomography
X-Ray Computed
Zdroj: The International Journal of Cardiovascular Imaging
International Journal of Cardiovascular Imaging, 36(1), 123-129. Springer Netherlands
The international journal of cardiovascular imaging
ISSN: 1875-8312
1569-5794
Popis: Valve size selection for transcatheter aortic valve replacement (TAVR) is currently based on cardiac CT-scan. At variance with patient-specific computer simulation, this does not allow the assessment of the valve-host interaction. We aimed to compare clinical valve size selection and valve size selection by an independent expert for computer simulation. A multicenter retrospective analysis of valve size selection by the physician and the independent expert in 141 patients who underwent TAVR with the self-expanding CoreValve or Evolut R. Baseline CT-scan was used for clinical valve size selection and for patient-specific computer simulation. Simulation results were not available for clinical use. Overall true concordance between clinical and simulated valve size selection was observed in 47 patients (33%), true discordance in 15 (11%) and ambiguity in 79 (56%). In 62 (44%, cohort A) one valve size was simulated whereas two valve sizes were simulated in 79 (56%, cohort B). In cohort A, concordance was 76% and discordance was 24%; a smaller valve size was selected for simulation in 10 patients and a larger in 5. In cohort B, a different valve size was selected for simulation in all patients in addition to the valve size that was used for TAVR. The different valve size concerned a smaller valve in 45 patients (57%) and a larger in 34 (43%). Selection of the valve size differs between the physician and the independent computer simulation expert who used the same source of information. These findings indicate that valve sizing in TAVR is still more intricate than generally assumed.
Databáze: OpenAIRE
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