title: Multidetector row computed tomography parameters associated with paravalvular regurgitation after transcatheter aortic valve implantation.
abstract: Multidetector row computed tomographic (MDCT) assessment of aortic annulus dimensions and frame position and deployment have been associated with paravalvular aortic regurgitation (PAVR) after transcatheter aortic valve implantation (TAVI). The present evaluation investigated the (pre- and postprocedure) MDCT associates of PAVR ≥2+. In total, 123 patients referred for TAVI underwent clinical evaluation, transthoracic echocardiography, and pre- and post-TAVI MDCT. Pre-TAVI MDCT measurements of the aortic annular dimensions and post-TAVI MDCT evaluation of the position and deployment of the prosthesis in the native annulus were performed. At 1-month follow-up, PAVR ≥2+ was observed in 25 patients (20%). The difference between the MDCT-derived maximum aortic annulus and the nominal diameters of the implanted prosthesis (odds ratio 1.912, p = 0.002) and shallow position of the frame in the left ventricular outflow tract (<2 mm) (odds ratio 4.865, p = 0.017) were independently related to significant PAVR. A maximum annulus diameter ≥2 mm larger than the nominal frame diameter had 72% sensitivity and 61% specificity to predict PAVR. In conclusion, in patients undergoing TAVI, ≥2-mm difference between maximum aortic annulus and nominal prosthesis diameters and depth of the frame into the left ventricular outflow tract of <2 mm are independently associated with PAVR ≥2+.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Katsanos
authors.forename: See Hooi
authors.initials: SH
authors.lastname: Ewe
authors.forename: Philippe
authors.initials: P
authors.lastname: Debonnaire
authors.forename: Frank
authors.initials: F
authors.lastname: van der Kley
authors.forename: Arend
authors.initials: A
authors.lastname: de Weger
authors.forename: Meindert
authors.initials: M
authors.lastname: Palmen
authors.forename: Arthur J H A
authors.initials: AJ
authors.lastname: Scholte
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Nina Ajmone
authors.initials: NA
authors.lastname: Marsan
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001022:Aortic Valve Insufficiency / Q000209:etiology*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery; D006328:Cardiac Catheterization; D018618:Echocardiography, Doppler, Color; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D016017:Odds Ratio; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000009:adverse effects*