Computed tomography guided sizing for transcatheter pulmonary valve replacement

Autor: Lara Curran, Harsh Agrawal, Kimberly Kallianos, Ahmed Kheiwa, Shezhang Lin, Karen Ordovas, Vaikom S Mahadevan
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: International Journal of Cardiology: Heart & Vasculature, Vol 29, Iss , Pp 100523- (2020)
Druh dokumentu: article
ISSN: 2352-9067
DOI: 10.1016/j.ijcha.2020.100523
Popis: Objective: To evaluate the predictive value of Computed Tomography Angiography (CTA) measurements of the RVOT for transcatheter valve sizing. Background: Transcatheter pulmonary valve replacement (TPVR) provides an alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction. We studied 18 patients who underwent catheterization for potential TPVR to determine whether CT imaging can be used to accurately predict implant size. Methods: Cases were grouped by RVOT characteristics: native or transannular patch (n = 8), conduit (n = 5) or bioprosthetic valve (n = 5). TPVR was undertaken in 14/18 cases, after balloon-sizing was used to confirm suitability and select implant size. Retrospective CT measurements of the RVOT (circumference-derived (Dcirc) and area-derived (Darea) diameters) were obtained at the level of the annulus, bioprosthesis or conduit. Using manufacturer sizing guidance, a valve size was generated and a predicted valve category assigned: (1) 29 mm. Predicted and implanted valves were compared for inter-rater agreement using Cohen’s kappa coefficient. Results: The median age of patients was 37 years old (IQR: 30–49); 55% were male. Diagnoses included: Tetralogy of Fallot (12/18), d-Transposition repair (3/18), congenital pulmonary stenosis (2/18) and carcinoid heart disease (1/18). Measurements of Darea (κ = 0.697, p
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