Format

Send to

Choose Destination
See comment in PubMed Commons below
Heart. 2012 Aug;98(16):1229-36. doi: 10.1136/heartjnl-2012-301998.

Intraoperative 2D and 3D transoesophageal echocardiographic predictors of aortic regurgitation after transcatheter aortic valve implantation.

Author information

1
Centro Cardiologico Monzino, IRCCS, Milano, Italy. paola.gripari@ccfm.it

Abstract

BACKGROUND:

Post-procedural aortic regurgitation (AR) has been described in a large number of patients receiving transcatheter aortic valve implantation (TAVI).

OBJECTIVE:

The aim of this study was to examine the intraoperative 2-dimensional (2D) and 3-dimensional (3D) echocardiographic features of the aortic valve associated with significant post-procedural paravalvular AR.

METHODS:

A total of 135 patients (81±7 years) with severe symptomatic aortic stenosis, who underwent TAVI, were imaged with comprehensive 2D and 3D transoesophageal echocardiography before the procedure and peri-procedure. Various baseline and peri-procedural echocardiographic characteristics were tested to predict paravalvular AR post-TAVI: calcifications at the aortic valve commissures and leaflets, 'aortic annulus eccentricity index', 'area cover index', overlap between aortic prosthesis and anterior mitral leaflet. Post-procedural paravalvular AR≥2 was considered significant.

RESULTS:

Successful TAVI was achieved in all patients. The incidence of paravalvular AR≥2 immediately after the procedure was 21% (28 patients). Commissural calcifications and, particularly, the calcification of the commissure between the right coronary and non-coronary cusps was significantly more frequent in presence of paravalvular AR; the area cover index pre-TAVI was significantly lower among patients with AR (11.1±11.8% vs 20.8±12.5%, p=0.0004). Multivariate analysis revealed that calcification of the commissure between the right coronary and non-coronary cusps (OR=2.66, 95% CI 1.39 to 5.12, p=0.001), and the area cover index pre-TAVI (OR=0.95, 95% CI 0.91 to 0.99, p=0.006) were the only independent predictors of significant paravalvular AR after TAVI.

CONCLUSIONS:

Intraoperative 2D and 3D transoesophageal echocardiography identified calcification of the commissure between the right coronary and non-coronary cusps and the area cover index as independent predictors of significant paravalvular AR following TAVI.

PMID:
22826560
DOI:
10.1136/heartjnl-2012-301998
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Support Center