Details

Autor(en) / Beteiligte

• Jilaihawi, Hasan, MD
• Doctor, Niraj, MBBS
• Kashif, Mohammad, MD
• Chakravarty, Tarun, MD
• Rafique, Asim, MD
• Makar, Moody, MD
• Furugen, Azusa, MD, PhD
• Nakamura, Mamoo, MD
• Mirocha, James, MS
• Gheorghiu, Mitch, MD
• Stegic, Jasminka, MS, ANP-BC, CCRN, ACNP
• Okuyama, Kazuaki, MD
• Sullivan, Daniel J., MD
• Siegel, Robert, MD
• Min, James K., MD
• Gurudevan, Swaminatha V., MD
• Fontana, Gregory P., MD
• Cheng, Wen, MD
• Friede, Gerald, BS, MS
• Shiota, Takahiro, MD
• Makkar, Raj R., MD

Titel

Aortic Annular Sizing for Transcatheter Aortic Valve Replacement Using Cross-Sectional 3-Dimensional Transesophageal Echocardiography

Ist Teil von

• Journal of the American College of Cardiology, 2013-03, Vol.61 (9), p.908-916

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2013

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Objectives This study compared cross-sectional three-dimensional (3D) transesophageal echocardiography (TEE) to two-dimensional (2D) TEE as methods for predicting aortic regurgitation after transcatheter aortic valve replacement (TAVR). Background Data have shown that TAVR sizing using cross-sectional contrast computed tomography (CT) parameters is superior to 2D-TEE for the prediction of paravalvular aortic regurgitation (AR). Three-dimensional TEE can offer cross-sectional assessment of the aortic annulus but its role for TAVR sizing has been poorly elucidated. Methods All patients had severe symptomatic aortic stenosis and were treated with balloon-expandable TAVR in a single center. Patients studied had both 2D-TEE and 3D imaging (contrast CT and/or 3D-TEE) of the aortic annulus at baseline. Receiver-operating characteristic curves were generated for each measurement parameter using post-TAVR paravalvular AR moderate or greater as the state variable. Results For the 256 patients studied, paravalvular AR moderate or greater occurred in 26 of 256 (10.2%) of patients. Prospectively recorded 2D-TEE measurements had a low discriminatory value (area under the curve = 0.52, 95% confidence interval: 0.40 to 0.63, p = 0.75). Average cross-sectional diameter by CT offered a high degree of discrimination (area under the curve = 0.82, 95% confidence interval: 0.73 to 0.90, p < 0.0001) and mean cross-sectional diameter by 3D-TEE was of intermediate value (area under the curve = 0.68, 95% confidence interval: 0.54 to 0.81, p = 0.036). Conclusions Cross-sectional 3D echocardiographic sizing of the aortic annulus dimension offers discrimination of post-TAVR paravalvular AR that is significantly superior to that of 2D-TEE. Cross-sectional data should be sought from 3D-TEE if good CT data are unavailable for TAVR sizing.