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Role of Multislice Computed Tomography in Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement (TAVR) required precise knowledge of the anatomic dimensions and physical characteristics of the aortic valve, annulus, and aortic root. Most groups currently use angiography, transthoracic echocardiography (TTE), or transesophageal echocardiography (TEE) to as... Full description

Journal Title: The American journal of cardiology 2009, Vol.103 (9), p.1295-1301
Main Author: Wood, David A., MD
Other Authors: Tops, Laurens F., MD , Mayo, John R., MD , Pasupati, Sanjeevan, MD , Schalij, Martin J., MD, PhD , Humphries, Karin, DSc , Lee, May, MSc , Al Ali, Abdullah, MD , Munt, Brad, MD , Moss, Rob, MD , Thompson, Christopher R., MD , Bax, Jeroen J., MD, PhD , Webb, John G., MD
Format: Electronic Article Electronic Article
Language: English
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Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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title: Role of Multislice Computed Tomography in Transcatheter Aortic Valve Replacement
format: Article
creator:
  • Wood, David A., MD
  • Tops, Laurens F., MD
  • Mayo, John R., MD
  • Pasupati, Sanjeevan, MD
  • Schalij, Martin J., MD, PhD
  • Humphries, Karin, DSc
  • Lee, May, MSc
  • Al Ali, Abdullah, MD
  • Munt, Brad, MD
  • Moss, Rob, MD
  • Thompson, Christopher R., MD
  • Bax, Jeroen J., MD, PhD
  • Webb, John G., MD
subjects:
  • Abridged Index Medicus
  • Aged
  • Aged, 80 and over
  • Aortic Valve - diagnostic imaging
  • Aortic Valve - surgery
  • Biological and medical sciences
  • Cardiac Catheterization - methods
  • Cardiology
  • Cardiology. Vascular system
  • Cardiovascular
  • Cohort Studies
  • Coronary vessels
  • Correlation analysis
  • CT imaging
  • Echocardiography - methods
  • Echocardiography, Transesophageal - methods
  • Female
  • Follow-Up Studies
  • Heart valve diseases
  • Heart Valve Diseases - diagnosis
  • Heart Valve Diseases - surgery
  • Heart Valve Prosthesis Implantation - methods
  • Humans
  • Imaging, Three-Dimensional - methods
  • Implants, Artificial
  • Male
  • Medical imaging
  • Medical sciences
  • Middle Aged
  • Minimally Invasive Surgical Procedures - methods
  • Prosthesis
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Tomography
  • Tomography, X-Ray Computed - methods
  • Treatment Outcome
ispartof: The American journal of cardiology, 2009, Vol.103 (9), p.1295-1301
description: Transcatheter aortic valve replacement (TAVR) required precise knowledge of the anatomic dimensions and physical characteristics of the aortic valve, annulus, and aortic root. Most groups currently use angiography, transthoracic echocardiography (TTE), or transesophageal echocardiography (TEE) to assess aortic annulus dimensions and anatomy. However, multislice computed tomography (MSCT) may allow more detailed 3-dimensional assessment of the aortic root. Twenty-six patients referred for TAVR underwent MSCT. Scans were also obtained for 18 patients after TAVR. All patients underwent pre- and postprocedural aortic root angiography, TTE, and TEE. Mean differences in measured aortic annular diameters were 1.1 mm (95% confidence interval 0.5, 1.8) for calibrated angiography and TTE, −0.9 mm (95% confidence interval −1.7, −0.1 mm) for TTE and TEE, −0.3 mm (95% confidence interval −1.1, 0.6 mm) for MSCT (sagittal) and TTE, and −1.2 mm (95% confidence interval −2.2, −0.2 mm) for MSCT (sagittal) and TEE. Coronal systolic measurements using MSCT, which corresponded to angiographic orientation, were 3.2 mm (1st and 3rd quartiles 2.6, 3.9) larger than sagittal systolic measurements, which were in the same anatomic plane as standard TTE and TEE views. There was no significant association between either shape of the aortic annulus or amount of aortic valve calcium and development of perivalvular aortic regurgitation. After TAVR, the prosthesis extended to or beyond the inferior border of the left main ostium in 9 of 18 patients (50%), and in 11 patients (61%), valvular calcium was
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleRole of Multislice Computed Tomography in Transcatheter Aortic Valve Replacement
creatorWood, David A., MD ; Tops, Laurens F., MD ; Mayo, John R., MD ; Pasupati, Sanjeevan, MD ; Schalij, Martin J., MD, PhD ; Humphries, Karin, DSc ; Lee, May, MSc ; Al Ali, Abdullah, MD ; Munt, Brad, MD ; Moss, Rob, MD ; Thompson, Christopher R., MD ; Bax, Jeroen J., MD, PhD ; Webb, John G., MD
creatorcontribWood, David A., MD ; Tops, Laurens F., MD ; Mayo, John R., MD ; Pasupati, Sanjeevan, MD ; Schalij, Martin J., MD, PhD ; Humphries, Karin, DSc ; Lee, May, MSc ; Al Ali, Abdullah, MD ; Munt, Brad, MD ; Moss, Rob, MD ; Thompson, Christopher R., MD ; Bax, Jeroen J., MD, PhD ; Webb, John G., MD
descriptionTranscatheter aortic valve replacement (TAVR) required precise knowledge of the anatomic dimensions and physical characteristics of the aortic valve, annulus, and aortic root. Most groups currently use angiography, transthoracic echocardiography (TTE), or transesophageal echocardiography (TEE) to assess aortic annulus dimensions and anatomy. However, multislice computed tomography (MSCT) may allow more detailed 3-dimensional assessment of the aortic root. Twenty-six patients referred for TAVR underwent MSCT. Scans were also obtained for 18 patients after TAVR. All patients underwent pre- and postprocedural aortic root angiography, TTE, and TEE. Mean differences in measured aortic annular diameters were 1.1 mm (95% confidence interval 0.5, 1.8) for calibrated angiography and TTE, −0.9 mm (95% confidence interval −1.7, −0.1 mm) for TTE and TEE, −0.3 mm (95% confidence interval −1.1, 0.6 mm) for MSCT (sagittal) and TTE, and −1.2 mm (95% confidence interval −2.2, −0.2 mm) for MSCT (sagittal) and TEE. Coronal systolic measurements using MSCT, which corresponded to angiographic orientation, were 3.2 mm (1st and 3rd quartiles 2.6, 3.9) larger than sagittal systolic measurements, which were in the same anatomic plane as standard TTE and TEE views. There was no significant association between either shape of the aortic annulus or amount of aortic valve calcium and development of perivalvular aortic regurgitation. After TAVR, the prosthesis extended to or beyond the inferior border of the left main ostium in 9 of 18 patients (50%), and in 11 patients (61%), valvular calcium was <5 mm from the left main ostium. In conclusion, MSCT identified that the aortic annulus was commonly eccentric and often oval. This may in part explain the small, but clinically insignificant, differences in measured aortic annular diameters with other imaging modalities. MSCT after TAVR showed close proximity of both the prosthesis and displaced valvular calcium to the left main ostium in most patients. Neither eccentricity nor calcific deposits appeared to contribute significantly to severity of paravalvular regurgitation after TAVR.
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languageeng
publisherNew York, NY: Elsevier Inc
subjectAbridged Index Medicus ; Aged ; Aged, 80 and over ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; Biological and medical sciences ; Cardiac Catheterization - methods ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cohort Studies ; Coronary vessels ; Correlation analysis ; CT imaging ; Echocardiography - methods ; Echocardiography, Transesophageal - methods ; Female ; Follow-Up Studies ; Heart valve diseases ; Heart Valve Diseases - diagnosis ; Heart Valve Diseases - surgery ; Heart Valve Prosthesis Implantation - methods ; Humans ; Imaging, Three-Dimensional - methods ; Implants, Artificial ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Minimally Invasive Surgical Procedures - methods ; Prosthesis ; Risk Assessment ; Sensitivity and Specificity ; Severity of Illness Index ; Tomography ; Tomography, X-Ray Computed - methods ; Treatment Outcome
ispartofThe American journal of cardiology, 2009, Vol.103 (9), p.1295-1301
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8Munt, Brad, MD
9Moss, Rob, MD
10Thompson, Christopher R., MD
11Bax, Jeroen J., MD, PhD
12Webb, John G., MD
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0Role of Multislice Computed Tomography in Transcatheter Aortic Valve Replacement
1The American journal of cardiology
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descriptionTranscatheter aortic valve replacement (TAVR) required precise knowledge of the anatomic dimensions and physical characteristics of the aortic valve, annulus, and aortic root. Most groups currently use angiography, transthoracic echocardiography (TTE), or transesophageal echocardiography (TEE) to assess aortic annulus dimensions and anatomy. However, multislice computed tomography (MSCT) may allow more detailed 3-dimensional assessment of the aortic root. Twenty-six patients referred for TAVR underwent MSCT. Scans were also obtained for 18 patients after TAVR. All patients underwent pre- and postprocedural aortic root angiography, TTE, and TEE. Mean differences in measured aortic annular diameters were 1.1 mm (95% confidence interval 0.5, 1.8) for calibrated angiography and TTE, −0.9 mm (95% confidence interval −1.7, −0.1 mm) for TTE and TEE, −0.3 mm (95% confidence interval −1.1, 0.6 mm) for MSCT (sagittal) and TTE, and −1.2 mm (95% confidence interval −2.2, −0.2 mm) for MSCT (sagittal) and TEE. Coronal systolic measurements using MSCT, which corresponded to angiographic orientation, were 3.2 mm (1st and 3rd quartiles 2.6, 3.9) larger than sagittal systolic measurements, which were in the same anatomic plane as standard TTE and TEE views. There was no significant association between either shape of the aortic annulus or amount of aortic valve calcium and development of perivalvular aortic regurgitation. After TAVR, the prosthesis extended to or beyond the inferior border of the left main ostium in 9 of 18 patients (50%), and in 11 patients (61%), valvular calcium was <5 mm from the left main ostium. In conclusion, MSCT identified that the aortic annulus was commonly eccentric and often oval. This may in part explain the small, but clinically insignificant, differences in measured aortic annular diameters with other imaging modalities. MSCT after TAVR showed close proximity of both the prosthesis and displaced valvular calcium to the left main ostium in most patients. Neither eccentricity nor calcific deposits appeared to contribute significantly to severity of paravalvular regurgitation after TAVR.
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0Abridged Index Medicus
1Aged
2Aged, 80 and over
3Aortic Valve - diagnostic imaging
4Aortic Valve - surgery
5Biological and medical sciences
6Cardiac Catheterization - methods
7Cardiology
8Cardiology. Vascular system
9Cardiovascular
10Cohort Studies
11Coronary vessels
12Correlation analysis
13CT imaging
14Echocardiography - methods
15Echocardiography, Transesophageal - methods
16Female
17Follow-Up Studies
18Heart valve diseases
19Heart Valve Diseases - diagnosis
20Heart Valve Diseases - surgery
21Heart Valve Prosthesis Implantation - methods
22Humans
23Imaging, Three-Dimensional - methods
24Implants, Artificial
25Male
26Medical imaging
27Medical sciences
28Middle Aged
29Minimally Invasive Surgical Procedures - methods
30Prosthesis
31Risk Assessment
32Sensitivity and Specificity
33Severity of Illness Index
34Tomography
35Tomography, X-Ray Computed - methods
36Treatment Outcome
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titleRole of Multislice Computed Tomography in Transcatheter Aortic Valve Replacement
authorWood, David A., MD ; Tops, Laurens F., MD ; Mayo, John R., MD ; Pasupati, Sanjeevan, MD ; Schalij, Martin J., MD, PhD ; Humphries, Karin, DSc ; Lee, May, MSc ; Al Ali, Abdullah, MD ; Munt, Brad, MD ; Moss, Rob, MD ; Thompson, Christopher R., MD ; Bax, Jeroen J., MD, PhD ; Webb, John G., MD
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1Aged
2Aged, 80 and over
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4Aortic Valve - surgery
5Biological and medical sciences
6Cardiac Catheterization - methods
7Cardiology
8Cardiology. Vascular system
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10Cohort Studies
11Coronary vessels
12Correlation analysis
13CT imaging
14Echocardiography - methods
15Echocardiography, Transesophageal - methods
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17Follow-Up Studies
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20Heart Valve Diseases - surgery
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29Minimally Invasive Surgical Procedures - methods
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31Risk Assessment
32Sensitivity and Specificity
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34Tomography
35Tomography, X-Ray Computed - methods
36Treatment Outcome
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abstractTranscatheter aortic valve replacement (TAVR) required precise knowledge of the anatomic dimensions and physical characteristics of the aortic valve, annulus, and aortic root. Most groups currently use angiography, transthoracic echocardiography (TTE), or transesophageal echocardiography (TEE) to assess aortic annulus dimensions and anatomy. However, multislice computed tomography (MSCT) may allow more detailed 3-dimensional assessment of the aortic root. Twenty-six patients referred for TAVR underwent MSCT. Scans were also obtained for 18 patients after TAVR. All patients underwent pre- and postprocedural aortic root angiography, TTE, and TEE. Mean differences in measured aortic annular diameters were 1.1 mm (95% confidence interval 0.5, 1.8) for calibrated angiography and TTE, −0.9 mm (95% confidence interval −1.7, −0.1 mm) for TTE and TEE, −0.3 mm (95% confidence interval −1.1, 0.6 mm) for MSCT (sagittal) and TTE, and −1.2 mm (95% confidence interval −2.2, −0.2 mm) for MSCT (sagittal) and TEE. Coronal systolic measurements using MSCT, which corresponded to angiographic orientation, were 3.2 mm (1st and 3rd quartiles 2.6, 3.9) larger than sagittal systolic measurements, which were in the same anatomic plane as standard TTE and TEE views. There was no significant association between either shape of the aortic annulus or amount of aortic valve calcium and development of perivalvular aortic regurgitation. After TAVR, the prosthesis extended to or beyond the inferior border of the left main ostium in 9 of 18 patients (50%), and in 11 patients (61%), valvular calcium was <5 mm from the left main ostium. In conclusion, MSCT identified that the aortic annulus was commonly eccentric and often oval. This may in part explain the small, but clinically insignificant, differences in measured aortic annular diameters with other imaging modalities. MSCT after TAVR showed close proximity of both the prosthesis and displaced valvular calcium to the left main ostium in most patients. Neither eccentricity nor calcific deposits appeared to contribute significantly to severity of paravalvular regurgitation after TAVR.
copNew York, NY
pubElsevier Inc
pmid19406275
doi10.1016/j.amjcard.2009.01.034