BACKGROUND: To investigate the causes of paravalvular aortic regurgitation (PAR) after the implantation of the Medtronic CoreValve prosthesis (MCRS). METHODS AND RESULTS: Fifty-six patients underwent MSCT before TAVI with a MCRS and PAR was assessed with transthoracic echocardiography (TTE) between 5 and 10 days after TAVI. The aortic annulus smallest and largest orthogonal diameters and the mean diameter from the area were determined on MSCT on an axial image at the nadir of all three native leaflets. PAR was related to relevant anatomical structures on MSCT according to a clockface in the orientation of the parasternal short axis view on TTE. PAR ≥ 1 was present in 25% of the patients and was associated with a larger annulus, a lower degree of over sizing and with more aortic root calcification. On MSCT post TAVI malapposition was seen predominantly at the aorto-mitral fibrous continuity and the aspect of the largest diameter of the aortic annulus on the inside curve of the ascending aorta. PAR was predominantly seen at these two anatomic locations and less frequent in the area that contains the ventricular membranous septum and the area between the non- and right coronary sinus. CONCLUSIONS: Mild to moderate PAR is common after TAVI with the MCRS. The availability of additional (larger) prosthesis sizes in combination with improved sizing based on mean annulus diameter (e.g., D(CSA)) may help to reduce PAR.
BACKGROUND: To investigate the causes of paravalvular aortic regurgitation (PAR) after the implantation of the Medtronic CoreValve prosthesis (MCRS). METHODS AND RESULTS: Fifty-six patients underwent MSCT before TAVI with a MCRS and PAR was assessed with transthoracic echocardiography (TTE) between 5 and 10 days after TAVI. The aortic annulus smallest and largest orthogonal diameters and the mean diameter from the area were determined on MSCT on an axial image at the nadir of all three native leaflets. PAR was related to relevant anatomical structures on MSCT according to a clockface in the orientation of the parasternal short axis view on TTE. PAR ≥ 1 was present in 25% of the patients and was associated with a larger annulus, a lower degree of over sizing and with more aortic root calcification. On MSCT post TAVI malapposition was seen predominantly at the aorto-mitral fibrous continuity and the aspect of the largest diameter of the aortic annulus on the inside curve of the ascending aorta. PAR was predominantly seen at these two anatomic locations and less frequent in the area that contains the ventricular membranous septum and the area between the non- and right coronary sinus. CONCLUSIONS: Mild to moderate PAR is common after TAVI with the MCRS. The availability of additional (larger) prosthesis sizes in combination with improved sizing based on mean annulus diameter (e.g., D(CSA)) may help to reduce PAR.
Authors: Nadja Wystub; Laura Bäz; Sven Möbius-Winkler; Tudor C Pörner; Björn Goebel; Ali Hamadanchi; Torsten Doenst; Julia Grimm; Lukas Lehmkuhl; Ulf Teichgräber; P Christian Schulze; Marcus Franz Journal: Clin Res Cardiol Date: 2019-04-10 Impact factor: 5.460
Authors: Rebecca T Hahn; Susheel Kodali; E Murat Tuzcu; Martin B Leon; Samir Kapadia; Deepika Gopal; Stamatios Lerakis; Brian R Lindman; Zuyue Wang; John Webb; Vinod H Thourani; Pamela S Douglas Journal: JACC Cardiovasc Imaging Date: 2015-03
Authors: Agata Wiktorowicz; Adrian Wit; Krzysztof Piotr Malinowski; Artur Dziewierz; Lukasz Rzeszutko; Dariusz Dudek; Pawel Kleczynski Journal: Quant Imaging Med Surg Date: 2021-02
Authors: Luigi F M Di Martino; Wim B Vletter; Ben Ren; Carl Schultz; Nicolas M Van Mieghem; Osama I I Soliman; Matteo Di Biase; Peter P de Jaegere; Marcel L Geleijnse Journal: Int J Cardiovasc Imaging Date: 2015-07-18 Impact factor: 2.357
Authors: Marcel L Geleijnse; Luigi F M Di Martino; Wim B Vletter; Ben Ren; Tjebbe W Galema; Nicolas M Van Mieghem; Peter P T de Jaegere; Osama I I Soliman Journal: Cardiovasc Ultrasound Date: 2016-09-06 Impact factor: 2.062