A discrepancy between CT angiography and transesophageal echocardiographic measurements of the annular size affect long-term survival following trans-catheter aortic valve replacement
| Autor: | Leili Pourafkari, Piotr S. Rutkowski, Alexey N. Dyachkov, Vijay Iyer, Nader D. Nader, Siddarth Singh |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Aortic valve
medicine.medical_treatment replacement computed tomographic Valve replacement Aortic valve replacement Aortic Valve Annulus medicine echocardiography Diseases of the circulatory (Cardiovascular) system angiography Cardiac skeleton cardiovascular diseases trans-catheter aortic valve Survival rate Computed tomography angiography medicine.diagnostic_test business.industry aortic stenosis medicine.disease medicine.anatomical_structure RC666-701 Angiography cardiovascular system Original Article Cardiology and Cardiovascular Medicine Nuclear medicine business human activities |
| Zdroj: | Journal of Cardiovascular and Thoracic Research, Vol 13, Iss 3, Pp 208-215 (2021) Journal of Cardiovascular and Thoracic Research |
| ISSN: | 2008-6830 2008-5117 |
| Popis: | Introduction: Accurate measurement of the aortic valve annulus is critical for proper valve sizing for the transcatheter aortic valve replacement (TAVR) procedure. While computed tomography angiography (CTA) is the widely-accepted standard, two-dimensional (2D) and three-dimensional(3D) transesophageal echocardiography (TEE) is commonly performed to measure the size of the aortic valve and to verify appropriate seating of prostheses. Methods: Patients undergoing TAVR between 2013-2015 were examined. 2D- and 3D-TEEmeasurements were compared to CTA taken as standard. Patients were followed for at least one year. The presence and effect of discrepancy (defined as a difference of more than 10%) between CTA and TEE measurements on survival were examined. Results: One hundred eighty-five patients (70 men) were included. 2D- and 3D-TEE measurements underestimated the annulus size by -1.49 and -1.32 mm, respectively. Discrepancies > 10% between TEE and CTA methods in estimating the aortic annulus size were associated with a decrease in post implant survival. The peak pressure gradient across the aortic prosthesis measured one year after the implant was higher in patients with an initial discrepancy between 3D-TEE and CTA measurements. In a multivariate cox-regression model, the discrepancy between CTA and 2D-TEE readings and the smaller size of the aortic annular area were the predictors of long-term survival. Conclusion: Both 2D and 3D-TEE underestimate the aortic annulus measurements compared to CTA, with 2D-TEE being relatively more precise than 3D-TEE technology. The presence of a discrepancy between echocardiographic and CTA measurements of the aortic annulus is associated with a lower survival rate. |
| Databáze: | OpenAIRE |
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