title: Determinants of image quality of rotational angiography for on-line assessment of frame geometry after transcatheter aortic valve implantation.
abstract: To study the determinants of image quality of rotational angiography using dedicated research prototype software for motion compensation without rapid ventricular pacing after the implantation of four commercially available catheter-based valves. Prospective observational study including 179 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with either the Medtronic CoreValve (MCS), Edward-SAPIEN Valve (ESV), Boston Sadra Lotus (BSL) or Saint-Jude Portico Valve (SJP) in whom rotational angiography (R-angio) with motion compensation 3D image reconstruction was performed. Image quality was evaluated from grade 1 (excellent image quality) to grade 5 (strongly degraded). Distinction was made between good (grades 1, 2) and poor image quality (grades 3-5). Clinical (gender, body mass index, Agatston score, heart rate and rhythm, artifacts), procedural (valve type) and technical variables (isocentricity) were related with the image quality assessment. Image quality was good in 128 (72 %) and poor in 51 (28 %) patients. By univariable analysis only valve type (BSL) and the presence of an artefact negatively affected image quality. By multivariate analysis (in which BMI was forced into the model) BSL valve (Odds 3.5, 95 % CI [1.3-9.6], p = 0.02), presence of an artifact (Odds 2.5, 95 % CI [1.2-5.4], p = 0.02) and BMI (Odds 1.1, 95 % CI [1.0-1.2], p = 0.04) were independent predictors of poor image quality. Rotational angiography with motion compensation 3D image reconstruction using a dedicated research prototype software offers good image quality for the evaluation of frame geometry after TAVI in the majority of patients. Valve type, presence of artifacts and higher BMI negatively affect image quality.
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus Medical Center, 's-Gravendijkwaal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Ramón
authors.initials: R
authors.lastname: Rodríguez-Olivares
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus Medical Center, 's-Gravendijkwaal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Nahid
authors.initials: N
authors.lastname: El Faquir
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus Medical Center, 's-Gravendijkwaal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Zouhair
authors.initials: Z
authors.lastname: Rahhab
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus Medical Center, 's-Gravendijkwaal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Maugenest
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus Medical Center, 's-Gravendijkwaal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Van Mieghem
authors.affiliation: Department of Cardiology, Royal Perth Hospital Campus, School of Medicine and Pharmacology, University of Western Australia, Crawley, Australia.
authors.forename: Carl
authors.initials: C
authors.lastname: Schultz
authors.affiliation: Siemens Healthcare GmbH, Forchheim, Germany.
authors.forename: Guenter
authors.initials: G
authors.lastname: Lauritsch
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus Medical Center, 's-Gravendijkwaal 230, 3015 CE, Rotterdam, The Netherlands. p.dejaegere@erasmusmc.nl.
authors.forename: Peter P T
authors.initials: PP
authors.lastname: de Jaegere
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D016477:Artifacts; D015992:Body Mass Index; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D015203:Reproducibility of Results; D012984:Software; D016896:Treatment Outcome
keywords: Aortic stenosis; Image quality; Rotational angiography; Transcatheter aortic valve implantation