AIMS: We compared the measurement of aortic leaflet calcification on contrast and non-contrast MSCT and investigated predictors of the need for balloon post-dilatation after TAVI. METHODS AND RESULTS: In 110 patients, who had TAVI with a Medtronic CoreValve prosthesis (MCS) for symptomatic aortic stenosis, calcification of the aortic root was measured on non-contrast MSCT (conventionally) and on contrast MSCT (signal attenuation >450 Houndsfield units). Calcium volume was underestimated on contrast- when compared to non-contrast MSCT: median (IQ-range)=759 (466 to 1295) vs. 2016 (1376 to 3262) and the difference between the two methods increased with higher calcium volumes (correlation coefficient r=0.90). Calcium mass was only slightly underestimated on contrast vs. non-contrast MSCT: median (IQ-range)=441 (268 to 809) vs. 555 (341 to 950) and there was no association between the differences and increasing calcium mass (r=0.17). Balloon post-dilatation was performed for significant aortic regurgitation after TAVI in 11 of 110 patients. When compared to controls, the patients who required balloon post-dilatation had higher aortic leaflet calcium on contrast CT (p<0.01), higher aortic annulus diameters (p<0.01) and higher annulus to prosthesis area ratio (p=0.01). ROC curves demonstrated that aortic root or aortic leaflet calcium measured on either contrast- or non-contrast MSCT showed excellent discrimination for the requirement of balloon post-dilatation (area under ROC >0.80 for all), whereas the discriminatory value of aortic annulus dimensions was moderate (area under ROC=0.69) and that of prosthesis to annulus ratio was poor (area under ROC=0.36). CONCLUSIONS: Dense aortic leaflet calcification measured on contrast MSCT discerned well the need for balloon post-dilatation after TAVI with an MCS for significant PAR. Non-contrast MSCT may no longer be needed to quantify aortic root calcium before TAVI.
AIMS: We compared the measurement of aortic leaflet calcification on contrast and non-contrast MSCT and investigated predictors of the need for balloon post-dilatation after TAVI. METHODS AND RESULTS: In 110 patients, who had TAVI with a Medtronic CoreValve prosthesis (MCS) for symptomatic aortic stenosis, calcification of the aortic root was measured on non-contrast MSCT (conventionally) and on contrast MSCT (signal attenuation >450 Houndsfield units). Calcium volume was underestimated on contrast- when compared to non-contrast MSCT: median (IQ-range)=759 (466 to 1295) vs. 2016 (1376 to 3262) and the difference between the two methods increased with higher calcium volumes (correlation coefficient r=0.90). Calcium mass was only slightly underestimated on contrast vs. non-contrast MSCT: median (IQ-range)=441 (268 to 809) vs. 555 (341 to 950) and there was no association between the differences and increasing calcium mass (r=0.17). Balloon post-dilatation was performed for significant aortic regurgitation after TAVI in 11 of 110 patients. When compared to controls, the patients who required balloon post-dilatation had higher aortic leaflet calcium on contrast CT (p<0.01), higher aortic annulus diameters (p<0.01) and higher annulus to prosthesis area ratio (p=0.01). ROC curves demonstrated that aortic root or aortic leaflet calcium measured on either contrast- or non-contrast MSCT showed excellent discrimination for the requirement of balloon post-dilatation (area under ROC >0.80 for all), whereas the discriminatory value of aortic annulus dimensions was moderate (area under ROC=0.69) and that of prosthesis to annulus ratio was poor (area under ROC=0.36). CONCLUSIONS: Dense aortic leaflet calcification measured on contrast MSCT discerned well the need for balloon post-dilatation after TAVI with an MCS for significant PAR. Non-contrast MSCT may no longer be needed to quantify aortic root calcium before TAVI.
Authors: Won-Keun Kim; Johannes Blumenstein; Christoph Liebetrau; Andreas Rolf; Luise Gaede; Arnaud Van Linden; Mani Arsalan; Mirko Doss; Jan G P Tijssen; Christian W Hamm; Thomas Walther; Helge Möllmann Journal: Clin Res Cardiol Date: 2017-08-09 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: Bo Fu; Qingliang Chen; Feng Zhao; Zhigang Guo; Nan Jiang; Xu Wang; Wei Wang; Jiange Han; Li Yang; Yanbo Zhu; Yanhe Ma Journal: Ann Transl Med Date: 2020-07
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