| Intraoperative 2D and 3D transoesophageal echocardiographic predictors of aortic regurgitation after transcatheter aortic valve implantation. | |
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MedLine Citation:
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PMID: 22826560 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Post-procedural aortic regurgitation (AR) has been described in a large number of patients receiving transcatheter aortic valve implantation (TAVI). OBJECTIVE: The aim of this study was to examine the intraoperative 2-dimensional (2D) and 3-dimensional (3D) echocardiographic features of the aortic valve associated with significant post-procedural paravalvular AR. METHODS: A total of 135 patients (81±7 years) with severe symptomatic aortic stenosis, who underwent TAVI, were imaged with comprehensive 2D and 3D transoesophageal echocardiography before the procedure and peri-procedure. Various baseline and peri-procedural echocardiographic characteristics were tested to predict paravalvular AR post-TAVI: calcifications at the aortic valve commissures and leaflets, 'aortic annulus eccentricity index', 'area cover index', overlap between aortic prosthesis and anterior mitral leaflet. Post-procedural paravalvular AR≥2 was considered significant. RESULTS: Successful TAVI was achieved in all patients. The incidence of paravalvular AR≥2 immediately after the procedure was 21% (28 patients). Commissural calcifications and, particularly, the calcification of the commissure between the right coronary and non-coronary cusps was significantly more frequent in presence of paravalvular AR; the area cover index pre-TAVI was significantly lower among patients with AR (11.1±11.8% vs 20.8±12.5%, p=0.0004). Multivariate analysis revealed that calcification of the commissure between the right coronary and non-coronary cusps (OR=2.66, 95% CI 1.39 to 5.12, p=0.001), and the area cover index pre-TAVI (OR=0.95, 95% CI 0.91 to 0.99, p=0.006) were the only independent predictors of significant paravalvular AR after TAVI. CONCLUSIONS: Intraoperative 2D and 3D transoesophageal echocardiography identified calcification of the commissure between the right coronary and non-coronary cusps and the area cover index as independent predictors of significant paravalvular AR following TAVI. |
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Authors:
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Paola Gripari; See Hooi Ewe; Laura Fusini; Manuela Muratori; Arnold C T Ng; Claudia Cefalù; Victoria Delgado; Martin J Schalij; Jeroen J Bax; Nina Ajmone Marsan; Gloria Tamborini; Mauro Pepi |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 98 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-07-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 1229-36 Citation Subset: AIM; IM |
Affiliation:
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Centro Cardiologico Monzino, Via Parea 4, Milan 20138, Italy; paola.gripari@ccfm.it. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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