| Feasibility and Accuracy of 3DTEE Versus CT for the Evaluation of Aortic Valve Annulus to Left Main Ostium Distance Before Transcatheter Aortic Valve Implantation. | |
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MedLine Citation:
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PMID: 22698526 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVES: The aims of this study were to analyze in a large series of patients undergoing transcatheter aortic valve implantation (TAVI): 1) the accuracy of 3-dimensional transesophageal echocardiographic (3DTEE) measurement of left coronary cusp (LCC) length and of the distances from left main coronary ostium (LM) to the aortic annulus (AA) pre-operatively and to the aortic prosthesis post-operatively; and 2) the role of the 3DTEE measurements in predicting the prosthetic deployment and the association between prosthesis position and aortic regurgitation (AR) and/or prosthesis-patient mismatch (PPM). BACKGROUND: Coronary ostia occlusion is a possible complication in TAVI; therefore, the careful pre-operative evaluation of AA-LM and LCC length, and the post-operative analysis of the relationship between the prosthesis and LM, may influence the procedural outcomes. Even though multidetector computed tomography (MDCT) is the gold standard pre-operatively, sometimes it cannot be performed and it is rarely repeated post-operatively. METHODS: In 122 patients undergoing TAVI, pre-operative AA-LM and LCC measurements obtained by 3DTEE and MDCT were compared. Post-operatively, the feasibility of 3DTEE evaluation of the prosthesis-LM distance was performed. The relationship between 3DTEE overlap of the prosthesis with the anterior mitral leaflet and AR/PPM was assessed. RESULTS: Pre-operatively, 3DTEE AA-LM (r = 0.83) and LCC (r = 0.69) significantly correlated with MDCT. Post-operatively, 3DTEE prosthesis-LM distance was 2.1 ± 1.9 mm. The prosthesis reached or exceeded LM in 6 and 10 cases, respectively. Prosthesis overlap with mitral leaflet was 4.7 ± 1.8 mm. Significant correlation between the 3DTEE computed and nominal length of the prosthesis was found (r = 0.61). No correlations were found between prosthesis-mitral leaflet overlap and aortic regurgitation or PPM. CONCLUSIONS: AA-LM distance and LCC length may be accurately estimated by 3DTEE, which may represent a valid alternative to MDCT. Pre- and post-3DTEE data concerning the aortic root, such as LM, aortic valve, and prosthetic morphology, give new insights into TAVI and its complications. |
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Authors:
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Gloria Tamborini; Laura Fusini; Paola Gripari; Manuela Muratori; Claudia Cefalù; Francesco Maffessanti; Francesco Alamanni; Antonio Bartorelli; Gianluca Pontone; Daniele Andreini; Erika Bertella; Cesare Fiorentini; Mauro Pepi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: JACC. Cardiovascular imaging Volume: 5 ISSN: 1876-7591 ISO Abbreviation: JACC Cardiovasc Imaging Publication Date: 2012 Jun |
Date Detail:
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Created Date: 2012-06-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101467978 Medline TA: JACC Cardiovasc Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 579-88 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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