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01.01.2018 | Original Article

Angles between the aortic root and the left ventricle assessed by MDCT are associated with the risk of aortic regurgitation after transcatheter aortic valve replacement

verfasst von: Vincent Roule, Alexandre Placente, Rémi Sabatier, Mathieu Bignon, Vladimir Saplacan, Calin Ivascau, Paul Milliez, Farzin Beygui

Erschienen in: Heart and Vessels | Ausgabe 1/2018

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Abstract

Objectives

To evaluate the impact of the angles quantified by multidetector computed tomography (MDCT) between the ascending aorta’s long axis and, the left ventricular inflow long axis (LVLA), or the left ventricule outflow tract long axis, and the occurrence of post-transcatheter aortic valve replacement (TAVR) aortic regurgitation (AR).

Methods

We prospectively included 136 consecutive patients who underwent a transfemoral TAVR with a preoperative MDCT. The groups were defined according to AR <2 or ≥2 assessed by echocardiography at 1 month.

Results

AR ≥2 identified in 21 patients (15.4%), was associated with increased rates of mortality (p value 0.02) and heart failure (p value 0.001) at 1-year follow-up. The aorta–LVLA angle was significantly higher in patients with AR ≥2 (130.5° ± 8.8° vs. 124.6° ± 9.5°; p = 0.009). On univariate analysis, aorta–LVLA angle was predictive of AR ≥2 [OR 1.07 per degree (1.02–1.13); p = 0.011]. After adjustment on annular calcification extent, the percentage of prosthesis-annular mismatch and the type of prosthesis, the relationship between aorta–LVLA angle and the risk of AR ≥2 remained unchanged.

Conclusions

We showed that increased angulation between the ascending aorta and the LVLA is associated with higher rates of AR post-TAVR independent of other potential correlates.

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Titel: Angles between the aortic root and the left ventricle assessed by MDCT are associated with the risk of aortic regurgitation after transcatheter aortic valve replacement
verfasst von: Vincent Roule
Alexandre Placente
Rémi Sabatier
Mathieu Bignon
Vladimir Saplacan
Calin Ivascau
Paul Milliez
Farzin Beygui
Publikationsdatum: 01.01.2018
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 1/2018
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-017-1032-1

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Angles between the aortic root and the left ventricle assessed by MDCT are associated with the risk of aortic regurgitation after transcatheter aortic valve replacement