Prediction of paravalvular leakage after transcatheter aortic valve implantation

Abstract Significant paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI) is related to patient mortality. Predicting the development of PVL has focused on computed tomography (CT) derived variables but literature targeting CoreValve devices is limited, controversial, and did not make use of standardized echocardiographic methods. The study included 164 consecutive patients with severe aortic stenosis that underwent TAVI with a Medtronic CoreValve system©, with available pre-TAVI CT and pre-discharge transthoracic echocardiography. The predictive value for significant PVL of the CT-derived Agatston score, aortic annulus size and eccentricity, and “cover index” was assessed, according to both echocardiographic Valve Academic Research Consortium (VARC) criteria and angiographic Sellers criteria. Univariate predictors for more than mild PVL were the maximal diameter of the aortic annulus size (for both angiographic and echocardiographic assessment of PVL), cover index (for echocardiographic assessment of PVL only), and Agatston score (for both angiographic and echocardiographic assessment of PVL). The aortic annulus eccentricity index was not predicting PVL. At multivariate analysis, Agatston score was the only independent predictor for both angiographic and echocardiographic assessment of PVL. Agatston score is the only independent predictor of PVL regardless of the used imaging technique for the definition of PVL.
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research

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Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Tags: Case report Source Type: research
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Source: Journal of Thoracic Imaging - Category: Radiology Tags: Original Articles Source Type: research
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Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
A previously asymptomatic fifty year old male presented with shortness of breath and chest pain for past 6 months. He underwent a transthoracic echocardiography which showed presence of a bicuspid aortic valve with severe stenosis. He further underwent CT angiography for evaluation of coronary arteries and aortic root dimensions. Review of CTA images incidentally revealed an anomalous origin of left circumflex artery (LCx) from the right pulmonary artery (RPA) (Figure 1A-B). The left anterior descending artery (LAD) and the right coronary artery (RCA) were dilated and extremely tortuous with extensive collateralization to ...
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Tags: Case report Source Type: research
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Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Tags: Case report Source Type: research
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Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
We aimed to evaluate the burden of coronary artery disease (CAD) using the computed tomography (CT) Leaman score in low-risk transcatheter aortic valve implantation (TAVI) patients. The extent of CAD in low-risk patients with aortic stenosis (AS) who are candidates for TAVI has not been accurately quantified. The CT Leaman score was developed to quantify coronary CT angiography (CCTA) atherosclerotic burden and has been validated to evaluate the extent of CAD. CT Leaman score>5 has been associated with an increase in major adverse cardiac events over long-term follow-up.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
We aimed to evaluate the burden of coronary artery disease (CAD) using the computed tomography (CT) Leaman score in low-risk transcatheter aortic valve implantation (TAVI) patients. The extent of CAD in low-risk patients with aortic stenosis who are candidates for TAVI has not been accurately quantified. The CT Leaman score was developed to quantify coronary CT angiography (CCTA) atherosclerotic burden and has been validated to evaluate the extent of CAD. CT Leaman score>5 has been associated with an increase in major adverse cardiac events over long-term follow-up.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
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Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
This study sought to derive and validate a systematic method enabling AVC quantification using computed tomography angiography (CTA) in patients with AS. METHODS: 134 consecutive patients with AS who underwent both NCCT and CTA were included in the study and sub-divided into derivation (n=71) and validation cohorts (n=63). On NCCT, AVC was quantified using Agatston method utilizing the software developed for semi-automatic assessment of coronary calcium. On CTA, mean contrast attenuation of aorta (AortaHU) and standard deviation (SD) was measured in the region-of-interest at level of sinotubular junction. RESULTS...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
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