Novel Real-Time Fluoroscopic Assessment Method of THV Expansion Following Balloon-Expandable TAVR.

Details

Serval ID
serval:BIB_EF62095A4B47
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Novel Real-Time Fluoroscopic Assessment Method of THV Expansion Following Balloon-Expandable TAVR.
Journal
Circulation. Cardiovascular interventions
Author(s)
Husain A., Tzimas G., Akodad M., Jelisejevas J., Offen S., Millar K., Leipsic J.A., Blanke P., Wood D.A., Sellers S.L., Webb J.G., Meier D., Sathananthan J.
ISSN
1941-7632 (Electronic)
ISSN-L
1941-7640
Publication state
Published
Issued date
02/2025
Peer-reviewed
Oui
Volume
18
Number
2
Pages
e014617
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Transcatheter heart valve (THV) underexpansion after transcatheter aortic valve replacement may be associated with worse outcomes. THV expansion can be assessed fluoroscopically using a pigtail for calibration; however, the accuracy of this technique specific to transcatheter aortic valve replacement is unknown. We assessed the accuracy and reproducibility of a novel fluoroscopic method to assess THV expansion using the THV commissural post for calibration.
Patients who underwent transcatheter aortic valve replacement with a SAPIEN 3 (S3) THV had documented 3 cusp and cusp overlap views, and post-implant computed tomography was identified. THV expansion was fluoroscopically assessed in the 3 cusp and cusp overlap views using the S3 commissural post height and the pigtail as a reference for calibration. The correlation between the 2 methods and computed tomography was evaluated.
Forty patients were included. On the bench, the commissural post height measured 3.3, 3.5, 4.0, and 4.5 mm for the 20 mm S3, 23 mm S3, 26 mm S3, and 29 mm S3, respectively. The Pearson correlation coefficient (r) with computed tomography for measuring the inflow, mid-portion, and outflow THV diameter was 0.98, 0.97, and 0.98 for the commissural post height method and 0.82, 0.81, and 0.78 for the pigtail method, respectively. Unlike the pigtail method, the correlation between the commissural post height method and computed tomography remained strong across all THV sizes and in both the 3 cusp and cusp overlap views.
The commissural post height method is a novel real-time fluoroscopic tool that has the potential to assess THV expansion and guide further optimization after balloon-expandable transcatheter aortic valve replacement.
Keywords
Humans, Fluoroscopy, Transcatheter Aortic Valve Replacement/adverse effects, Transcatheter Aortic Valve Replacement/instrumentation, Aortic Valve/surgery, Aortic Valve/diagnostic imaging, Aortic Valve/physiopathology, Female, Male, Aged, 80 and over, Aortic Valve Stenosis/surgery, Aortic Valve Stenosis/diagnostic imaging, Aortic Valve Stenosis/physiopathology, Predictive Value of Tests, Aged, Reproducibility of Results, Heart Valve Prosthesis, Treatment Outcome, Balloon Valvuloplasty/adverse effects, Prosthesis Design, Time Factors, Retrospective Studies, Tomography, X-Ray Computed, calibration, humans, reproducibility of results, tomography, x-ray computed, transcatheter aortic valve replacement
Pubmed
Web of science
Create date
24/01/2025 16:35
Last modification date
25/02/2025 7:06
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