Abstract 16112: Aortic Annulus Parameters Pre-Interventionally Assessed by Cardiac Computed Tomography Could Not Predict the Occurrence of Post-Interventional Paravalvular Aortic Regurgitation
Background: Transcatheter Aortic Valve Implantation (TAVI) has emerged as a reliable option for selected patients who have a high operative risk. However some patients will develop postprocedural aortic regurgitation (AR). Though more than 10.000 patients received this alternative therapy, there is still limited data on geometric annulus variables, that might predict the occurrence of AR. The aim of our study was therefore to identify such parameters by using Multi Detector-CT prior to TAVI.
Methods: 72 consecutive patients (36 male, mean age 82.3±6.4y) underwent retrospectively gated cardiac CT angiography (CTA) (Siemens Somatom Definition) and conventional echocardiography 24–48h prior to percutaneous aortic valve implant. The diameters of the aortic annulus were assessed using both CTA and echocardiography. The elliptic annulus area and its excentricity were calculated. For CTA multiplanar reconstructions at 0.75 mm were used. The preprocedural diameters and excentricity measures were compared for the different degrees of postinterventional AR using an ANOVA model.
Results: Mean diameter of the MDCT-assessed aortic annulus were 25x23 mm in patients with AR 0 (n = 22), 26x24 mm in patients with AR I (n = 29), 27x24 mm in patients with AR II (n = 20) and 30x25 mm in the only one patient with AR III (overall p = 0,201). The mean area and mean excentricity were 3,01 cm2 and 0,19 in AR 0, 3,47 cm2 and 0,19 in AR I, 3,4 cm2 and 0,28 in AR II and 4,01 cm2 and 0,15 in AR III (overall p = 0,56 and p = 0,621).
Conclusion: Despite increasing annulus parameters (diameter, area and eccentricity) with each degree of AR severity there was no statistically significant difference between groups and thus no clear predictive value of these parameters.
- © 2010 by American Heart Association, Inc.