The extent of aortic annulus calcification is a predictor of postprocedural eccentricity and paravalvular regurgitation

• Verfasst von: Bekeredjian, Raffi [VerfasserIn]
• Verfasst von: Bodingbauer, Dorothea [VerfasserIn]
• Verfasst von: Hofmann, Nina [VerfasserIn]
• Verfasst von: Greiner, Sebastian [VerfasserIn]
• Verfasst von: Schütz, Moritz [VerfasserIn]
• Verfasst von: Geis, Nicolas [VerfasserIn]
• Verfasst von: Kauczor, Hans-Ulrich [VerfasserIn]
• Verfasst von: Bryant, Mark [VerfasserIn]
• Verfasst von: Chorianopoulos, Emmanuel [VerfasserIn]
• Verfasst von: Pleger, Sven Torsten [VerfasserIn]
• Verfasst von: Mereles, Derliz [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Korosoglou, Grigorios [VerfasserIn]
• Titel: The extent of aortic annulus calcification is a predictor of postprocedural eccentricity and paravalvular regurgitation
• Titelzusatz: a pre- and postinterventional cardiac computed tomography angiography study
• Verf.angabe: Raffi Bekeredjian, MD; Dorothea Bodingbauer, MD; Nina P. Hofmann, MD; Sebastian Greiner, MD; Moritz Schuetz, MD; Nicolas A. Geis, MD; Hans U. Kauczor, MD; Mark Bryant, MD; Emmanuel Chorianopoulos; Sven T. Pleger; Derliz Mereles, MD; Hugo A. Katus, MD; Grigorios Korosoglou, MD
• E-Jahr: 2015
• Jahr: February 24, 2015
• Umfang: 9 S.
• Fussnoten: Gesehen am 29.05.2020
• Titel Quelle: Enthalten in: The journal of invasive cardiology
• Ort Quelle: Wayne, Pa. : HMP Communications, LLC, 1998
• Jahr Quelle: 2015
• Band/Heft Quelle: 27(2015), Seite 172-80
• ISSN Quelle: 1557-2501
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1699036640

Abstract

To investigate if the extent of aortic valve calcification is associated with postprocedural prosthesis eccentricity and paravalvular regurgitation (PAR) in patients undergoing transcatheter aortic valve implantation (TAVI). - Cardiac computed tomography angiography (CCTA) was performed before and 3 months after TAVI in 46 patients who received the self-expanding CoreValve and in 22 patients who underwent balloon-expandable Edwards Sapien XT implantation. Aortic annulus calcification was measured with CCTA prior to TAVI and prosthesis eccentricity was assessed with post-TAVI CCTA. Standard echocardiography was also performed in all patients at 3-month follow-up exam. - Annulus eccentricity was reduced during TAVI using both implantation systems (from 0.23 ± 0.06 to 0.18 ± 0.07 using CoreValve and from 0.20 ± 0.07 to 0.05 ± 0.03 using Edwards Sapien XT; P<.001 for both). With Edwards Sapien XT, eccentricity reduction at the level of the aortic annulus was significantly higher compared with CoreValve (P<.001). Annulus eccentricity after CoreValve use was significantly related to absolute valve calcification and to valve calcification indexed to body surface area (BSA) (r = 0.48 and 0.50, respectively; P<.001 for both). Furthermore, a significant association was observed between aortic valve calcification and PAR (P<.01 by ANOVA) in patients who received CoreValve. Using ROC analysis, a cut-off value over 913 mm² aortic valve calcification predicted the occurrence of moderate or severe PAR with a sensitivity of 92% and a specificity of 63% (area under the curve = 0.75). Furthermore, multivariable analysis showed that aortic valve calcification was a robust predictor of postprocedural eccentricity and PAR, independent of the aortic annulus size and native valve eccentricity and of CoreValve prosthesis size (adjusted r = 0.46 and 0.50, respectively; P<.01 for both). Such associations were not present with the Edwards Sapien XT system. - The extent of native aortic annulus calcification is predictive for postprocedural prosthesis eccentricity and PAR, which is an important marker for long-term mortality in patients undergoing TAVI. This observation applies for the CoreValve, but not for the Edwards Sapien XT valve.