학술논문
HIT Poster session 3
Document Type
Article
Author
Stella, S; Rosa, I; Marini, C; Ancona, F; Spagnolo, P; Latib, A; Romano, V; Colombo, A; Margonato, A; Agricola, E; Li, H; Yuan, L; Xie, MX; Jin, XY; Stathogiannis, K; Toutouzas, K; Drakopoulou, M; Latsios, G; Synetos, A; Sanidas, E; Kaitozis, O; Trantalis, G; Gerckens, U; Tousoulis, D; Stojkovic, S; Tesic, M; Stojkovic, S; Stepanovic, J; Trifunovic, D; Beleslin, B; Giga, V; Nedeljkovic, I; Djordjevic Dikic, A; Ondrus, T; Bartunek, J; Vanderheyden, M; Stockman, B; Mirica, C; Kotrc, M; Van Praet, F; Van Camp, G; Penicka, M; Plaza Lopez, D; Igual Munoz, B; Sanchez Lacuesta, ME; Lopez Vilella, R; Domenech Tort, MD; Sepulveda Sanchis, P; Ten Morro, F; Calvillo Batlles, P; Montero Argudo, JA; Martinez Dolz, LV; Jinno, S; Yamada, A; Sugimoto, K; Ito, S; Kato, M; Inuzuka, H; Sugiyama, H; Takada, K; Ozaki, Y; Ishii, J; Verseckaite, R; Mizariene, V; Gaileviciute, K; Bieseviciene, M; Jonkaitiene, R; Jurkevicius, R; Oliveira Da Silva, C; Gunyeli, E; Winter, R; Back, M; Settergren, M; Manouras, A; Shahgaldi, K; Altin, C; Ozsoy, HM; Gezmis, E; Yilmaz, M; Tunc, E; Sade, LE; Muderrisoglu, H; Krestjyaninov, MV; Gimaev, RH; Melnikova, MA; Olezov, NV; Ruzov, VI; Izci, S; Dogan, C; Acar, R; Cetin, G; Bakal, RB; Unkun, T; Cap, M; Erdogan, E; Kaymaz, C; Ozdemir, N; Santos, M; Leite, L; Martins, R; Baptista, R; Barbosa, A; Ribeiro, N; Oliveira, A; Castro, G; Pego, M; Urbano-Moral, JA; Gutierrez-Garcia-Moreno, L; Rodriguez-Palomares, JF; Galuppo, V; Maldonado-Herrera, G; Teixido-Tura, G; Gruosso, D; Gonzalez-Alujas, T; Evangelista-Massip, A; Spartera, M; Stella, S; Rosa, I; Ancona, F; Marini, C; Latib, A; Giannini, F; Colombo, A; Margonato, A; Agricola, E; Gonzalvez-Garcia, A; Urbano-Moral, JA; Matabuena-Gomez-Limon, J; Grande-Trillo, A; Rojas-Bermudez, C; Rodriguez-Puras, MJ; Martinez-Martinez, A; Lopez-Pardo, F; Lopez-Haldon, JE; Miskowiec, D; Kupczynska, K; Kasprzak, JD; Lipiec, P; Hagrass, MUHAMMAD; Abdelrahman Sharaf El Dein, AHMED; Shawky El Serafy, AHMED; Rajan, RAJESH; Rady, M; Sveric, K; Kvakan, H; Strasser, RH; Reskovic Luksic, V; Cekovic, S; Veceric, S; Separovic Hanzevacki, J; Castaldi, B; Romanato, S; Callegari, A; Bernardinello, V; Reffo, E; Milanesi, O; Silva, T; Agapito, A; Sousa, L; Oliveira, JA; Branco, LM; Timoteo, AT; Galrinho, A; Thomas, B; Tavares, NJ; Cruz Ferreira, R; Silva, T; Agapito, A; Sousa, L; Oliveira, JA; Branco, LM; Timoteo, AT; Galrinho, A; Thomas, B; Tavares, NJ; Cruz Ferreira, R; Silva, T; Agapito, A; Sousa, L; Oliveira, JA; Soares, R; Aguiar Rosa, SA; Morais, L; Thomas, B; Tavares, NJ; Cruz Ferreira, R; Kolossvary, M; Szilveszter, B; Elzomor, H; Karolyi, M; Raaijmakers, R; Benke, K; Celeng, C; Bagyura, Z; Merkely, B; Maurovich-Horvat, P; Basuoni, A; Shaheen, S; Abdelkader, M; Rasheed, T; Miskowiec, D; Kasprzak, JD; Lipiec, P; Peovska Mitevska, I; Srbinovska, E; Pop Gorceva, D; Zdravkovska, M; Aguiar Rosa, S; Galrinho, A; Moura Branco, L; Timoteo, AT; Agapito, A; Sousa, L; Oliveira, JA; Rodrigues, I; Viveiros Monteiro, A; Cruz Ferreira, R
Source
European Journal of Echocardiography; December 2015, Vol. 16 Issue: Supplement 2 pS142-S142, 1p
Subject
Language
ISSN
15252167; 15322114
Abstract
Purpose: the assessment of aortic annular size in TAVI patients, is critical and inappropriate sizing is a main reason of paravalvular aortic regurgitation (PVR). Data on aortic annulus measures assessed by 3D-Transesophageal Echocardiography (3D-TEE) compared to Multislice Computed Tomography (MSCT), are limited and discordant. The aim was to compare aortic annulus measurements obtained by 3D-TEE with MSCT, evaluating the impact on prosthesis size selection and their ability to predict PVR ≥ mild. Materials and Methods: 53 consecutive TAVI patients (mean age 81.5 ± 5.2 years, 22 women) underwent both 3D-TEE and MSCT. The 3D volume dataset was acquired containing the LVOT, aortic annulus/valve and aortic root. 3D-echocardiographic reconstruction for measurement of the aortic annulus was performed with a dedicated software (EchoPac). This allowed for precise identification of the annular plane from orthogonal views, to accurately perform mid-systole measurements. MSCT measurements were obtained in diastole. The final valve sizing was based on MSCT measurements. Then 3D-TEE data were submitted to one TAVI operator for blinded definition of prosthesis sizing, in order to test the agreement between the two modalities. Finally, Cover Index (CI) and absolute difference (Δ) between prosthesis size and 3D-TEE and MSCT annulus measures, were assessed for estimation of PVR ≥ mild predictivity. Results: although absolute differences were small, 3D-TEE measurements were statistically significantly smaller than MDCT ones: for major (coronal) diameter a mean difference=−2.3 mm (range, −2.1 to 6.7 mm, p= 0.0001), mean perimeter difference=−3.9 mm (range, −8.0 to 15,9 mm, p=0.006) and a mean area difference=−2.8 cm2 (range, −6.6 to 12.3 cm2, p=0.05), with the exception of minor (sagittal) diameter (mean difference= 0.02 ± 3 mm, p= 0.9), with a very good correlation for minor (sagittal) diameter and area (r= 0.76 and 0.79, respectively, p=0.0001). We found a 68% of concordance between 3D-TEE and MSCT for the implanted prosthesis size. Among the 32% of discordance, 3D-TEE lead to prosthesis underestimation in most of cases. Only MSCT perimeter measurement had statistically higher predictive value for the presence of ≥ mild PVR (AUC for Δ Perimeter and CI Perimeter=0.77 and 0.72, respectively). Conclusion: 3D-TEE annulus measurements of sagittal diameter and area evaluated in mid-systole well correlate to MDCT measurements in diastole. Moreover there is a moderate concordance between the two modalities, for final prosthesis sizing. Only MSCT perimeter measurement, predict post-TAVI PVR with good accuracy.