Abstract 4624: Usefulness of Echocardiographic Scoring of Valve Morphology for Transcatheter Aortic Valve
Objectives: An echocardiographic scoring (calcification score and symmetry score) was developed to predict the functional outcome after transcatheter aortic valve implantation (T-AVI) with regard to postoperative regurgitation and safety of valve implantation.
Methods: 212 high-risk patients underwent transapical AVI at Leipzig since February 2006, digitalized preoperative transesophageal echocardiography (TEE) data from 103 patients (82.2±5.9 years men age, 46% male, mean logistic Euroscore 33.0±16.3%) were available for this study. Aortic root dimensions, aortic valve haemodynamic function, T-AVI echo calcification score (from 0=normal to 8=diffuse calcification of the aortic cusps and commissures) and T-AVI echo symmetry score (class of symmetricity from 0=minimum to 6=maximum symmetry) were assessed by an independent examiner. Aortic incompetence was judged according to the vena contracta and pressure half time determinations.
Results: The mean T-AVI echo calcification score was 6.9±1.9 and correlated significantly to the presence of moderate paravalvular leak (OR 8.47, 95% CI 1.22 to 58.92, p=0.0001) and to the presence of moderate overall grade of aortic regurgitation (OR 3.59, 95% CI 1.24 to 10.41, p=0.0006). The T-AVI echo symmetry score was significantly correlated also to both paravalvular leak (OR 13.7, 95% CI 1.52 to 122.4, p=0.0051) and to overall aortic regurgitation (OR 17.04, 95% CI 1.95 to 148.6, p=0.0014).
Conclusions: Echocardiography has an important role in the screening of patients for transcatheter AVI. Assessment of aortic root morphology and calcification pattern in detail is important for successful implantations. Both scores were useful preoperative tools predicting the risk of postoperative paravalvular leak and overall prosthesis regurgitation.