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Erschienen in: The International Journal of Cardiovascular Imaging 4/2020

08.01.2020 | Original Paper

Impact of aortic valve calcification severity on device success after transcatheter aortic valve replacement

verfasst von: Jeremy Larroche, Loïc Panh, Thibault Lhermusier, Vincent Bataille, Marie-Agnès Marachet, Thomas Chollet, Antoine Petermann, Frederic Bouisset, Nicolas Boudou, Bertrand Marcheix, Hervé Rousseau, Michel Galinier, Didier Carrié, Olivier Lairez, Yoan Lavie-Badie

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 4/2020

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Abstract

Aortic valvular calcium score (AVCS) can identify severe aortic stenosis (AS) and provide powerful prognostic information. In severe and symptomatic AS, patients can be referred for a transcatheter aortic valve replacement (TAVR). The aim of this study was to determine whether AVCS, measured on the preoperative contrast enhanced multislice computed tomography (MSCT), is associated with device success (DS), major adverse cardiac events (MACEs) and paravalvular leak (PVL) after TAVR. Three hundred and fifty-two consecutive patients who underwent TAVR with a preoperative standardised contrast enhanced MSCT were included in the study. Valvular calcification detection was defined by adding + 100 Hounsfield Unit (HU) to mean HU determined by a region of interest placed in the contrast enhanced ascending aorta. AVCS was then indexed to the aortic annulus surface (AVCSi). Endpoints were DS and 30-day MACE according to Valve Academic Research Consortium-2 consensus document, and moderate to severe PVL. DS was obtained for 305 patients. In multivariate analysis, AVCSi was negatively and independently associated with DS: OR = 0.99, 95% CI 0.99–0.99, p = 0.03. In the subgroup analysis, this association was particularly relevant with self-expanding prostheses [n = 151 (43%), p = 0.018] and in the cases of asymmetric calcium valvular distribution [n = 283 (80%), p 0.002]. There was no association between MACE and AVCS (p = 0.953) and AVCSi (p = 0.757). PVL was positively associated with AVCS (p < 0.001) and AVCSi (p < 0.001). In conclusion, in TAVR, AVCS, measured on preoperative contrast enhanced MSCT, is significantly associated with DS and PVL, but not with 30-day MACE. Its routine use could be relevant to appreciate success chances of TAVR.
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Literatur
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Metadaten
Titel
Impact of aortic valve calcification severity on device success after transcatheter aortic valve replacement
verfasst von
Jeremy Larroche
Loïc Panh
Thibault Lhermusier
Vincent Bataille
Marie-Agnès Marachet
Thomas Chollet
Antoine Petermann
Frederic Bouisset
Nicolas Boudou
Bertrand Marcheix
Hervé Rousseau
Michel Galinier
Didier Carrié
Olivier Lairez
Yoan Lavie-Badie
Publikationsdatum
08.01.2020
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 4/2020
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-019-01759-7

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