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J Am Soc Echocardiogr. 2010 Apr;23(4):370-6. doi: 10.1016/j.echo.2010.01.020.

Immediate and long-term echocardiographic findings after transcatheter aortic valve implantation for the treatment of aortic stenosis: the Cribier-Edwards/Edwards-Sapien valve experience.

Author information

1
Division of Cardiology, Rouen University Hospital, Rouen, France. fabrice.bauer@chu-rouen.fr

Abstract

BACKGROUND:

The role of transcatheter aortic valve implantation in the treatment of calcific aortic stenosis is evolving. Immediate and long-term echocardiographic findings are poorly reported.

METHODS:

Eighty-eight patients in whom surgical aortic valve replacement was contraindicated were studied before and 1 and 7 days, 1 month, and 1 and 2 years after the transcatheter procedure by echocardiography for hemodynamic. Transaortic pressure gradient, permeability index, and aortic valve area were measured, and aortic regurgitation was estimated from a multiparametric approach. A subset group of 36 patients (23-mm valve, n = 18; 26-mm valve, n = 18) with optimal ultrasound window were investigated for valve geometry at 7 days. We measured the sphericity index (anteroposterior to sagittal diameter ratio) and the angulation of the prosthesis with the ascending aorta.

RESULTS:

By analysis of variance, transaortic pressure gradient significantly decreased and aortic valve area increased after the procedure (P < .0001 and P < .0001 respectively). Aortic regurgitation severity tended to decline at follow-up (P = .20) and was unaffected by valve size (P = .35). Leaks were paraprosthetic in 77% of cases, intraprosthetic in 6% of cases, and both in 17% of cases. Overall, the sphericity index was 1.03 +/- 0.07 and the angulation was 2.9 +/- 1.1 degrees.

CONCLUSION:

Echocardiography aids in the demonstration of appropriate prosthesis function and positioning after transcatheter aortic valve implantation.

PMID:
20362925
DOI:
10.1016/j.echo.2010.01.020
[Indexed for MEDLINE]

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