In:
Journal of Interventional Cardiology, Wiley, Vol. 27, No. 3 ( 2014-06), p. 275-283
Abstract:
The long‐term success of CoreValve® stent prosthesis (Medtronic) implantation for severe aortic valve stenosis is limited by postprocedural paravalvular regurgitation (PVR) . Methods We have retrospectively investigated preinterventional cardiac 256‐slice computed tomography (CT) scans and aortography to define predictors for mild, moderate, or severe PVR, in a blinded fashion . Results We investigated 100 consecutive patients with a mean aortic valve area (AVA) of 0.69 cm 2 and a mean age of 79.4 years. PVR was defined by echocardiography as mild (63), moderate (18), or severe (19). We found no differences according to AVA, left ventricular function, deployed stent size, calcification rate of the aortic valve, and stent position. Anatomically, the annular size and the angle between the left ventricular outflow tract (LVOT) and the ascending aorta demonstrated significant (P 〈 0.05) differences in the severity of the PVR: an LVOT: ascending aorta angle 〉 12.6°, annulus area 〉 8.9 cm 2 , and annulus diameter difference 〉 3.9 mm. The multivariate analysis demonstrated that deviation angle, difference of aortic annulus (longitudinal–orthogonal), and CoreValve size were independent predictors of PVR . Conclusion Our data demonstrate the feasibility of cardiac CT to evaluate predictors of PVR post‐CoreValve placement. We support the aortic annulus (the area as well as the diameter differences) and the deviation of the linear slope from LVOT to ascending aorta as predictors of severe paravalvular regurgitations poststent implantation . (J Interven Cardiol 2014;27:275–283)
Type of Medium:
Online Resource
ISSN:
0896-4327
,
1540-8183
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2103585-4
