title: Evaluation of multislice computed tomography early after transcatheter aortic valve implantation with the Edwards SAPIEN bioprosthesis.
abstract: Currently, imaging assessment of patients who undergo transcatheter aortic valve implantation is based mainly on echocardiography and angiography, both limited to provide a 3-dimensional evaluation of the prosthesis within the native valve. This study involved 34 patients who underwent multislice computed tomography (MSCT) after transcatheter aortic valve implantation. Prosthesis expansion and circularity, depth of implantation, apposition degree at the ventriculoaortic junction, and positioning in relation to coronary artery ostia were evaluated. Early clinical events such as aortic regurgitation and periprocedural conduction abnormalities were recorded and correlated with multislice computed tomographic findings. MSCT provided comprehensive 3-dimensional assessments of the prostheses in 31 of 34 of patients (91%). Expansion was excellent (mean expansion ratio 100.0 ± 10.4%) and increased significantly from the ventricular side to the aortic side of the prosthesis. Circular deployment was achieved in most patients and increased from the ventricular to the aortic side. Mean implantation depth was -2.4 ± 2.5 mm, associated with a low rate (12%) of permanent pacemaker implantation. Patients with a new conduction abnormalities had the deepest prosthesis implantation, associated with lesser expansion and circularity. Perfect apposition on MSCT was associated with a low rate of significant aortic regurgitation. In conclusion, MSCT is able to provide an accurate 3-dimensional evaluation of prosthesis deployment and positioning after transcatheter aortic valve implantation. Moreover, these anatomic findings correlate with the most frequent early complications (i.e., the occurrence of aortic regurgitation and conduction abnormalities).
authors: Department of Radiology, Rouen University Hospital, Rouen, France.
authors: Jérôme
authors: J
authors: Caudron
authors: Jeannette
authors: J
authors: Fares
authors: Camille
authors: C
authors: Hauville
authors: Alain
authors: A
authors: Cribier
authors: Jean-Nicolas
authors: JN
authors: Dacher
authors: Christophe
authors: C
authors: Tron
authors: Fabrice
authors: F
authors: Bauer
authors: Pierre-Yves
authors: PY
authors: Litzler
authors: Jean-Paul
authors: JP
authors: Bessou
authors: Hélène
authors: H
authors: Eltchaninoff
mesh_terms: D000369:Aged, 80 and over; D000704:Analysis of Variance; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000601:surgery*; D001705:Bioprosthesis; D006328:Cardiac Catheterization; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005602:France; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome