Abstract 12987: Annulus Deformity Index Obtained by Using Four-dimension Multidetector Computed Tomography in Patients With Severe Aortic Stenosis is Useful for Predicting Over Moderate Paravalvular Regurgitation Immediately After Transcatheter Aortic Valve Replacement
Background: Correct assessment of annulus diameter before transcatheter aortic valve replacement (TAVR) using multidetector computed tomography (MDCT) is important to minimize complications such as annulus rupture and paravalvular aortic regurgitation (PVR). The form of the annulus was previously reported to be oval, while the form of the SAPIEN XT valve was circular. However, the association between the ellipsoid degree of annulus and PVR remains unclear. A new technique of measuring variability in a region of interest through a cardiac cycle using voxel tracking for image data obtained by four-dimensional MDCT (4D-MDCT) was recently reported. This technology allows evaluation of changes of the annulus through the cardiac cycle, and detection of the cardiac phase of maximum and minimum annulus area correctly compared with conventional methods. In the present study, we examined whether evaluating the annulus ellipsoid degree obtained by 4D-MDCT is useful for predicting the occurrence of PVR immediately after TAVR.
Methods: We performed 4D-MDCT in 72 patients with severe aortic valve stenosis before TAVR (mean age, 82 years; mean AVA, 0.61 cm2). All patients were implanted SAPIEN XT. The 4D-MDCT image data were analyzed offline on a workstation using a voxel-tracking method (Ziosoft Inc.). We defined the deformity index calculated as the ratio of short axis diameter to large axis diameter of the annulus.
Results: Mean R-R% of the maximum and minimum annulus area were 14.5% and 46.4%, respectively. Patients with PVR (n=20) had a significantly lower deformity index at maximum, minimum, and R-R 30% annulus area phase compared with no PVR patients. Receiver operating characteristic curve analysis showed that the deformity index at phase of maximum annulus area was an excellent marker for predicting PVR when compared to other cardiac phases (Figure).
Conclusion: Low deformity index obtained using 4D-MDCT may be a useful marker for predicting PVR immediately after TAVR.
Author Disclosures: H. Tamura: None. N. Iguchi: None. Y. Utanohara: None. K. Mahara: None. I. Takamisawa: None. A. Seki: None. M. Suzuki: None. T. Tobaru: None. M. Takayama: None. J. Umemura: None. T. Sumiyoshi: None. H. Tomoike: None.
- © 2015 by American Heart Association, Inc.