Predictors of calcification distribution in severe tricuspid aortic valve stenosis

AbstractWe investigated aortic valve calcification (AVC) distribution and predictors for leaflet calcification patterns in patients with severe tricuspid aortic valve stenosis undergoing transcatheter aortic valve replacement (TAVR). Patients undergoing routine multi-sliced computed tomography (MSCT) for procedural planning were enrolled. MSCT data were transferred to a dedicated workstation for evaluation (3mensio Structural Heart ™, Pie Medical Imaging BV, Maastricht, The Netherlands) and analyzed. Participants were separated into asymmetrical (AC) and symmetrical (SC) leaflet calcification and potential predictors for calcification distribution were identified with univariate and multivariate regression analysis. 567 Part icipants with severe tricuspid AS were divided into asymmetrical (AC, n = 443; 78.1%) and symmetrical (SC, n = 124; 21.9%) AVC. In AC, the non-coronary cusp was the most calcified cusp (n = 238; 57.7%). SC is more common in females (AC/SC: 49.2% vs. 67.7%; p <  0.0001). AVC was more severe in patients with AC, who also have larger aortic root dimensions. Multivariate analysis depicted, inter alia, left ventricular outflow tract (LVOT) calcification <  25 Agatston units (OR 1.81 [1.09–3.00], p = 0.021), a mean pressure gradient <  36 mmHg (OR 1.77 [1.03–3.05], p = 0.039), and an annulo-apical angle >  67° (OR 1.68 [1.00–2.80], p = 0.049) as predictors for SC, although with only moderate predictiv...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research