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Int J Cardiovasc Imaging. 2015 Oct;31(7):1461-8. doi: 10.1007/s10554-015-0703-1. Epub 2015 Jul 18.

Prediction of paravalvular leakage after transcatheter aortic valve implantation.

Author information

1
From the Department of Cardiology, Ospedali Riuniti, Università degli studi di Foggia, Foggia, Italy.
2
From the Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
3
From the Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. o.soliman@erasmusmc.nl.
4
From the Cardialysis Cardiovascular Core Laboratory, Rotterdam, The Netherlands. o.soliman@erasmusmc.nl.
5
From the Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. m.geleijnse@erasmusmc.nl.

Abstract

Significant paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI) is related to patient mortality. Predicting the development of PVL has focused on computed tomography (CT) derived variables but literature targeting CoreValve devices is limited, controversial, and did not make use of standardized echocardiographic methods. The study included 164 consecutive patients with severe aortic stenosis that underwent TAVI with a Medtronic CoreValve system©, with available pre-TAVI CT and pre-discharge transthoracic echocardiography. The predictive value for significant PVL of the CT-derived Agatston score, aortic annulus size and eccentricity, and "cover index" was assessed, according to both echocardiographic Valve Academic Research Consortium (VARC) criteria and angiographic Sellers criteria. Univariate predictors for more than mild PVL were the maximal diameter of the aortic annulus size (for both angiographic and echocardiographic assessment of PVL), cover index (for echocardiographic assessment of PVL only), and Agatston score (for both angiographic and echocardiographic assessment of PVL). The aortic annulus eccentricity index was not predicting PVL. At multivariate analysis, Agatston score was the only independent predictor for both angiographic and echocardiographic assessment of PVL. Agatston score is the only independent predictor of PVL regardless of the used imaging technique for the definition of PVL.

KEYWORDS:

Aortic valve; Computed tomography; Echocardiography; Paravalvular leakage; TAVI; Transcatheter

PMID:
26187523
PMCID:
PMC4572040
DOI:
10.1007/s10554-015-0703-1
[Indexed for MEDLINE]
Free PMC Article

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