title: Aortic annulus eccentricity before and after transcatheter aortic valve implantation: Comparison of balloon-expandable and self-expanding prostheses.
abstract: BACKGROUND
  The geometry of the aortic annulus and implanted transcatheter aortic valve prosthesis might influence valve function. We investigated the influence of valve type and aortic valve calcification on post-implant geometry of catheter-based aortic valve prostheses.
  
  
  METHODS
  Eighty consecutive patients with severe aortic valve stenosis (mean age 82 ± 6 years) underwent computed tomography before and after TAVI. Aortic annulus diameters were determined. Influence of prosthesis type and degree of aortic valve calcification on post-implant eccentricity were analysed.
  
  
  RESULTS
  Aortic annulus eccentricity was reduced in patients after TAVI (0.21 ± 0.06 vs. 0.08 ± 0.06, p<0.0001). Post-TAVI eccentricity was significantly lower in 65 patients following implantation of a balloon-expandable prosthesis as compared to 15 patients who received a self-expanding prosthesis (0.06 ± 0.05 vs. 0.15 ± 0.07, p<0.0001), even though the extent of aortic valve calcification was not different. After TAVI, patients with a higher calcium amount retained a significantly higher eccentricity compared to patients with lower amounts of calcium.
  
  
  CONCLUSIONS
  Patients undergoing TAVI with a balloon-expandable prosthesis show a more circular shape of the implanted prosthesis as compared to patients with a self-expanding prosthesis. Eccentricity of the deployed prosthesis is affected by the extent of aortic valve calcification.
authors.affiliation: Department of Cardiology, University of Erlangen, Erlangen, Germany. Electronic address: annika.schuhbaeck@uk-erlangen.de.
authors.forename: Annika
authors.initials: A
authors.lastname: Schuhbaeck
authors.affiliation: Department of Cardiology, University of Gießen, Giessen, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Weingartner
authors.affiliation: Department of Cardiology, University of Erlangen, Erlangen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Arnold
authors.affiliation: Department of Cardiology, University of Erlangen, Erlangen, Germany.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Schmid
authors.affiliation: Department of Cardiology, University of Erlangen, Erlangen, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Pflederer
authors.affiliation: Department of Cardiology, University of Erlangen, Erlangen, Germany.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Marwan
authors.affiliation: Department of Cardiology, University of Gießen, Giessen, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Rixe
authors.affiliation: Department of Cardiology, University of Gießen, Giessen, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Nef
authors.affiliation: Department of Radiology, University of Gießen, Giessen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schneider
authors.affiliation: Department of Radiology, University of Erlangen, Erlangen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Lell
authors.affiliation: Department of Radiology, University of Erlangen, Erlangen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Uder
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Ensminger
authors.affiliation: Department of Cardiothoracic Surgery, University of Erlangen, Erlangen, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: Feyrer
authors.affiliation: Department of Cardiothoracic Surgery, University of Erlangen, Erlangen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Weyand
authors.affiliation: Department of Cardiology, University of Erlangen, Erlangen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006328:Cardiac Catheterization; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome
keywords: Aortic valve stenosis; Cardiac imaging techniques; Heart valve prosthesis implantation; Multidetector computed tomography; Three-dimensional imaging of the aortic root