title: Prediction of paravalvular leakage after transcatheter aortic valve implantation.
abstract: Significant paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI) is related to patient mortality. Predicting the development of PVL has focused on computed tomography (CT) derived variables but literature targeting CoreValve devices is limited, controversial, and did not make use of standardized echocardiographic methods. The study included 164 consecutive patients with severe aortic stenosis that underwent TAVI with a Medtronic CoreValve system©, with available pre-TAVI CT and pre-discharge transthoracic echocardiography. The predictive value for significant PVL of the CT-derived Agatston score, aortic annulus size and eccentricity, and "cover index" was assessed, according to both echocardiographic Valve Academic Research Consortium (VARC) criteria and angiographic Sellers criteria. Univariate predictors for more than mild PVL were the maximal diameter of the aortic annulus size (for both angiographic and echocardiographic assessment of PVL), cover index (for echocardiographic assessment of PVL only), and Agatston score (for both angiographic and echocardiographic assessment of PVL). The aortic annulus eccentricity index was not predicting PVL. At multivariate analysis, Agatston score was the only independent predictor for both angiographic and echocardiographic assessment of PVL. Agatston score is the only independent predictor of PVL regardless of the used imaging technique for the definition of PVL.
authors.affiliation: From the Department of Cardiology, Ospedali Riuniti, Università degli studi di Foggia, Foggia, Italy.
authors.forename: Luigi F M
authors.initials: LF
authors.lastname: Di Martino
authors.affiliation: From the Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Wim B
authors.initials: WB
authors.lastname: Vletter
authors.affiliation: From the Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Ben
authors.initials: B
authors.lastname: Ren
authors.affiliation: From the Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Carl
authors.initials: C
authors.lastname: Schultz
authors.affiliation: From the Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Van Mieghem
authors.affiliation: From the Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. o.soliman@erasmusmc.nl.|From the Cardialysis Cardiovascular Core Laboratory, Rotterdam, The Netherlands. o.soliman@erasmusmc.nl.
authors.forename: Osama I I
authors.initials: OI
authors.lastname: Soliman
authors.affiliation: From the Department of Cardiology, Ospedali Riuniti, Università degli studi di Foggia, Foggia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Biase
authors.affiliation: From the Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Peter P
authors.initials: PP
authors.lastname: de Jaegere
authors.affiliation: From the Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Ba304, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. m.geleijnse@erasmusmc.nl.
authors.forename: Marcel L
authors.initials: ML
authors.lastname: Geleijnse
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D018618:Echocardiography, Doppler, Color; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D015588:Observer Variation; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Aortic valve; Computed tomography; Echocardiography; Paravalvular leakage; TAVI; Transcatheter