Henrik Fox1, Katrin Hemmann2, Ralf Lehmann3. 1. Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany. akleemeyer@hdz-nrw.de. 2. Department of Cardiology, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany. 3. Department of Cardiology, Krankenhaus Barmherzige Brüder, Regensburg, Germany.
Abstract
BACKGROUND: Untreated symptomatic high-grade aortic stenosis remains a lethal disease requiring individually adapted valve replacement. High-risk surgical patients benefit from transcatheter aortic valve replacement (TAVR), but there is no uniform standard for patient selection and valve sizing and it is still unclear whether transthoracic (TTE) or transesophageal (TEE) echocardiography is superior in preprocedural aortic annulus sizing. As preprocedural sizing of the native aortic annulus diameter is crucial to outcome and survival, we report the results of a direct comparison between preprocedural sizing with TTE and TEE including subsequent outcomes in a high-risk TAVR population. METHODS: A total of 149 TAVR patients were enrolled for TTE and TEE comparison, and an additional 15 patients without structural heart disease were investigated as control group to determine the influence of aortic valve calcification on TTE and TEE aortic annulus diameter measurements. RESULTS: Overall standardized TTE and TEE measurements for aortic annulus sizing showed excellent correlation at good image quality (p < 0.01, r = 0.934). Calcification of the aortic annulus diameter was not found to exert a noteworthy negative influence on measurements for both standardized TTE and TEE and complication rates did not differ for mortality, periprocedural stroke and paraprosthetic regurgitation. CONCLUSIONS: Transthoracic echocardiography and TEE are both equally suitable methods of preprocedural aortic annulus size evaluation in preparation of TAVR procedures.
BACKGROUND: Untreated symptomatic high-grade aortic stenosis remains a lethal disease requiring individually adapted valve replacement. High-risk surgical patients benefit from transcatheter aortic valve replacement (TAVR), but there is no uniform standard for patient selection and valve sizing and it is still unclear whether transthoracic (TTE) or transesophageal (TEE) echocardiography is superior in preprocedural aortic annulus sizing. As preprocedural sizing of the native aortic annulus diameter is crucial to outcome and survival, we report the results of a direct comparison between preprocedural sizing with TTE and TEE including subsequent outcomes in a high-risk TAVR population. METHODS: A total of 149 TAVR patients were enrolled for TTE and TEE comparison, and an additional 15 patients without structural heart disease were investigated as control group to determine the influence of aortic valve calcification on TTE and TEE aortic annulus diameter measurements. RESULTS: Overall standardized TTE and TEE measurements for aortic annulus sizing showed excellent correlation at good image quality (p < 0.01, r = 0.934). Calcification of the aortic annulus diameter was not found to exert a noteworthy negative influence on measurements for both standardized TTE and TEE and complication rates did not differ for mortality, periprocedural stroke and paraprosthetic regurgitation. CONCLUSIONS: Transthoracic echocardiography and TEE are both equally suitable methods of preprocedural aortic annulus size evaluation in preparation of TAVR procedures.
Authors: Oliver Husser; Simon Rauch; Dierk H Endemann; Markus Resch; Julio Nunez; Vicente Bodi; Michael Hilker; Christof Schmid; Günter A J Riegger; Andreas Luchner; Christian Hengstenberg Journal: Catheter Cardiovasc Interv Date: 2012-03-14 Impact factor: 2.692
Authors: Helmut Baumgartner; Philipp Bonhoeffer; Natasja M S De Groot; Fokko de Haan; John Erik Deanfield; Nazzareno Galie; Michael A Gatzoulis; Christa Gohlke-Baerwolf; Harald Kaemmerer; Philip Kilner; Folkert Meijboom; Barbara J M Mulder; Erwin Oechslin; Jose M Oliver; Alain Serraf; Andras Szatmari; Erik Thaulow; Pascal R Vouhe; Edmond Walma Journal: Eur Heart J Date: 2010-08-27 Impact factor: 29.983
Authors: Stephan Achenbach; Victoria Delgado; Jörg Hausleiter; Paul Schoenhagen; James K Min; Jonathon A Leipsic Journal: J Cardiovasc Comput Tomogr Date: 2012-11-14
Authors: Jeffrey J Popma; David H Adams; Michael J Reardon; Steven J Yakubov; Neal S Kleiman; David Heimansohn; James Hermiller; G Chad Hughes; J Kevin Harrison; Joseph Coselli; Jose Diez; Ali Kafi; Theodore Schreiber; Thomas G Gleason; John Conte; Maurice Buchbinder; G Michael Deeb; Blasé Carabello; Patrick W Serruys; Sharla Chenoweth; Jae K Oh Journal: J Am Coll Cardiol Date: 2014-03-19 Impact factor: 24.094
Authors: Henrik Fox; Katrin Hemmann; Mirko Doss; Andres Beiras-Fernandez; Andreas M Zeiher; Anton Moritz; Stephan Fichtlscherer; Ralf Lehmann Journal: Blood Coagul Fibrinolysis Date: 2013-10 Impact factor: 1.276
Authors: Laurens F Tops; David A Wood; Victoria Delgado; Joanne D Schuijf; John R Mayo; Sanjeevan Pasupati; Frouke P L Lamers; Ernst E van der Wall; Martin J Schalij; John G Webb; Jeroen J Bax Journal: JACC Cardiovasc Imaging Date: 2008-05
Authors: Robert R Moss; Emma Ivens; Sanjeevan Pasupati; Karin Humphries; Christopher R Thompson; Brad Munt; Ajay Sinhal; John G Webb Journal: JACC Cardiovasc Imaging Date: 2008-01
Authors: Tobias Szymczyk; Odile Sauzet; Lech J Paluszkiewicz; Angelika Costard-Jäckle; Max Potratz; Volker Rudolph; Jan F Gummert; Henrik Fox Journal: Int J Cardiovasc Imaging Date: 2020-05-22 Impact factor: 2.357
Authors: Xin Meng; Yandan Sun; Wei Bai; Yuxi Li; Shengjun Tuo; Liang Cao; Mengmeng Du; Yang Liu; Ping Jin; Jian Yang; Liwen Liu Journal: Ann Transl Med Date: 2022-01
Authors: Muhammed Gerçek; Olaf Oldenburg; Mustafa Gerçek; Henrik Fox; Volker Rudolph; Thomas Puehler; Hazem Omran; Lisa Katharina Wolf; Kavous Hakim-Meibodi; Andreas M Zeiher; Jan Gummert; Zisis Dimitriadis Journal: J Clin Med Date: 2021-05-10 Impact factor: 4.241