The feasibility of relaxation-enhanced angiography without contrast and triggering for preprocedural planning of transcatheter aortic valve implantation

Bibliographic Details
Title: The feasibility of relaxation-enhanced angiography without contrast and triggering for preprocedural planning of transcatheter aortic valve implantation
Authors: Rui Wang, Xinmin Liu, Jing Yao, U. Joseph Schoepf, Joseph Griffith, Jiayang Wang, Jianxiu Lian, Ke Jiang, Guangyuan Song, Lei Xu
Source: Frontiers in Cardiovascular Medicine, Vol 10 (2023)
Publisher Information: Frontiers Media S.A., 2023.
Publication Year: 2023
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
Subject Terms: transcatheter aortic valve implantation, CT angiography, MRI, cardiac MRI, 3D whole-heart MRI, Diseases of the circulatory (Cardiovascular) system, RC666-701
More Details: BackgroundCardiovascular MRI is advantageous in transcatheter aortic valve implantation (TAVI) planning. This study aimed to evaluate the feasibility of comprehensive non-contrast MRI [relaxation-enhanced angiography without contrast and triggering (REACT)] combined with a three-dimensional whole-heart MRI protocol for preprocedural planning of TAVI vs. computed tomography angiography (CTA).MethodsThirty patients with severe aortic stenosis were prospectively enrolled. The anatomical properties of the aortic root anatomy, including the perimeter and area of the virtual aortic valve annulus and coronary heights, were determined from 3D whole-heart MRI and cardiac CTA (CCTA) images, respectively. The diameters of the aorta (thoracic and abdominal aorta) and iliofemoral arteries were measured from REACT and aortic CTA (ACTA) images, respectively. A paired t-test was used to compare these two modalities. Bland–Altman plots were used to assess cardiovascular MRI and CTA measurements. Transcatheter heart valve (THV) sizing was performed based on CCTA measurements and compared with 3D whole-heart MRI measurements. The extent of annular calcification on 3D whole-heart MRI images was evaluated by a four-point grading scale and compared with CCTA data.ResultsAll 30 patients completed CTA and cardiovascular MRI examinations, with the TAVI procedure being administered in 25 patients. The mean acquisition time of the comprehensive MRI protocol was 18 ± 3.2 min. There were no significant differences between ACTA and REACT data in regard to the diameters of aortic and iliofemoral arteries, including the ascending thoracic aorta (37 ± 4.6 mm vs. 37.7 ± 5.2 mm, p = 0.085), descending thoracic aorta (24.3 ± 2.8 mm vs. 24.3 ± 2.8 mm, p = 0.832), abdominal aorta (20.9 ± 2.5 mm vs. 20.8 ± 2.5 mm, p = 0.602), bilateral common iliac arteries (right: 8.36 ± 1.44 mm vs. 8.42 ± 1.27 mm, p = 0.590; left: 8.61 ± 1.71 mm vs. 8.86 ± 1.46 mm, p = 0.050), and bilateral femoral arteries (right: 6.77 ± 1.06 mm vs. 6.87 ± 1.00 mm, p = 0.157; left: 6.75 ± 1.02 mm vs. 6.90 ± 0.80 mm, p = 0.142). Both modalities showed similar aortic valve morphology and semi-quantitative valve calcification (all, p's > 0.05). Overall agreement for implanted THV was found in all 25 (100%) patients assessed with both modalities.ConclusionREACT combined with 3D whole-heart MRI enables reliable measurements of aortic root anatomy, annular calcification, and aorta and iliofemoral access in patients under evaluation for TAVI.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2297-055X
Relation: https://www.frontiersin.org/articles/10.3389/fcvm.2023.1284743/full; https://doaj.org/toc/2297-055X
DOI: 10.3389/fcvm.2023.1284743
Access URL: https://doaj.org/article/131288db43f04781b25d04d8920a2149
Accession Number: edsdoj.131288db43f04781b25d04d8920a2149
Database: Directory of Open Access Journals
More Details
ISSN:2297055X
DOI:10.3389/fcvm.2023.1284743
Published in:Frontiers in Cardiovascular Medicine
Language:English