Transcatheter aortic valve implantation: role of multi-detector row computed tomography to evaluate prosthesis positioning and deployment in relation to valve function

Delgado, Victoria, Ng, Arnold C. T., van de Veire, Nico R., van der Kley, Frank, Schuijf, Joanne D., Tops, Laurens F., de Weger, Arend, Tavilla, Giuseppe, de Roos, Albert, Kroft, Lucia J., Schalij, Martin J. and Bax, Jeroen J. (2010) Transcatheter aortic valve implantation: role of multi-detector row computed tomography to evaluate prosthesis positioning and deployment in relation to valve function. European Heart Journal, 31 9: 1114-1123. doi:10.1093/eurheartj/ehq018


Author Delgado, Victoria
Ng, Arnold C. T.
van de Veire, Nico R.
van der Kley, Frank
Schuijf, Joanne D.
Tops, Laurens F.
de Weger, Arend
Tavilla, Giuseppe
de Roos, Albert
Kroft, Lucia J.
Schalij, Martin J.
Bax, Jeroen J.
Title Transcatheter aortic valve implantation: role of multi-detector row computed tomography to evaluate prosthesis positioning and deployment in relation to valve function
Journal name European Heart Journal   Check publisher's open access policy
ISSN 0195-668X
1522-9645
Publication date 2010-05-01
Year available 2010
Sub-type Article (original research)
DOI 10.1093/eurheartj/ehq018
Open Access Status Not yet assessed
Volume 31
Issue 9
Start page 1114
End page 1123
Total pages 10
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Aims: Aortic regurgitation after transcatheter aortic valve implantation (TAVI) is one of the most frequent complications. However, the underlying mechanisms of this complication remain unclear. The present evaluation studied the anatomic and morphological features of the aortic valve annulus that may predict aortic regurgitation after TAVI.

Methods and results In 53 patients with severe aortic stenosis undergoing TAVI, multi-detector row computed tomography (MDCT) assessment of the aortic valve apparatus was performed. For aortic valve annulus sizing, two orthogonal diameters were measured (coronal and sagittal). In addition, the extent of valve calcifications was quantified. At 1-month follow-up after procedure, MDCT was repeated to evaluate and correlate the prosthesis deployment to the presence of aortic regurgitation. Successful procedure was achieved in 48 (91) patients. At baseline, MDCT demonstrated an ellipsoid shape of the aortic valve annulus with significantly larger coronal diameter when compared with sagittal diameter (25.1 ± 2.4 vs. 22.9 ± 2.0 mm, P < 0.001). At follow-up, MDCT showed a non-circular deployment of the prosthesis in six (14) patients. Moderate post-procedural aortic regurgitation was observed in five (11) patients. These patients showed significantly larger aortic valve annulus (27.3 ± 1.6 vs. 24.8 ± 2.4 mm, P = 0.007) and more calcified native valves (4174 ± 1604 vs. 2444 ± 1237 HU, P = 0.005) at baseline and less favourable deployment of the prosthesis after TAVI.

Conclusion Multi-detector row computed tomography enables an accurate sizing of the aortic valve annulus and constitutes a valuable imaging tool to evaluate prosthesis location and deployment after TAVI. In addition, MDCT helps to understand the underlying mechanisms of post-procedural aortic regurgitation.
Keyword Transcatheter aortic valve implantation
Multi slice computed tomography
Aortic stenosis
Corevalve Revalving System
Valvular Heart Disease
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 30 Apr 2013, 21:19:34 EST by Dr Chin Tse Arnold Ng on behalf of School of Medicine