Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement

Bibliographic Details
Title: Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement
Authors: Mahmoud Abdelshafy, Patrick W. Serruys, Tsung-Ying Tsai, Pruthvi Chenniganahosahalli Revaiah, Scot Garg, Jean-Paul Aben, Carl J. Schultz, Mohammad Abdelghani, Pim A. L. Tonino, Yosuke Miyazaki, Marcel C. M. Rutten, Martijn Cox, Cherif Sahyoun, Justin Teng, Hiroki Tateishi, Mohamed Abdel-Wahab, Nicolo Piazza, Michele Pighi, Rodrigo Modolo, Martijn van Mourik, Joanna Wykrzykowska, Robbert J. de Winter, Pedro A. Lemos, Fábio S. de Brito, Hideyuki Kawashima, Lars Søndergaard, Liesbeth Rosseel, Rutao Wang, Chao Gao, Ling Tao, Andreas Rück, Won-Keun Kim, Niels van Royen, Christian J. Terkelsen, Henrik Nissen, Matti Adam, Tanja K. Rudolph, Hendrik Wienemann, Ryo Torii, Franz Josef Neuman, Simon Schoechlin, Mao Chen, Ahmed Elkoumy, Hesham Elzomor, Ignacio J. Amat-Santos, Darren Mylotte, Osama Soliman, Yoshinobu Onuma
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: aortic regurgitation, paravalvular leak, videodensitometry, transcatheter aortic valve replacement, transcatheter aortic valve implantation, quantitative aortography, Diseases of the circulatory (Cardiovascular) system, RC666-701
More Details: Paravalvular leak (PVL) is a shortcoming that can erode the clinical benefits of transcatheter valve replacement (TAVR) and therefore a readily applicable method (aortography) to quantitate PVL objectively and accurately in the interventional suite is appealing to all operators. The ratio between the areas of the time-density curves in the aorta and left ventricular outflow tract (LVOT-AR) defines the regurgitation fraction (RF). This technique has been validated in a mock circulation; a single injection in diastole was further tested in porcine and ovine models. In the clinical setting, LVOT-AR was compared with trans-thoracic and trans-oesophageal echocardiography and cardiac magnetic resonance imaging. LVOT-AR > 17% discriminates mild from moderate aortic regurgitation on echocardiography and confers a poor prognosis in multiple registries, and justifies balloon post-dilatation. The LVOT-AR differentiates the individual performances of many old and novel devices and is being used in ongoing randomized trials and registries.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2297-055X
Relation: https://www.frontiersin.org/articles/10.3389/fcvm.2023.1161779/full; https://doaj.org/toc/2297-055X
DOI: 10.3389/fcvm.2023.1161779
Access URL: https://doaj.org/article/44d275368d6f4cc5b7aa5e0f5c4469f3
Accession Number: edsdoj.44d275368d6f4cc5b7aa5e0f5c4469f3
Database: Directory of Open Access Journals
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  Data: Paravalvular leak (PVL) is a shortcoming that can erode the clinical benefits of transcatheter valve replacement (TAVR) and therefore a readily applicable method (aortography) to quantitate PVL objectively and accurately in the interventional suite is appealing to all operators. The ratio between the areas of the time-density curves in the aorta and left ventricular outflow tract (LVOT-AR) defines the regurgitation fraction (RF). This technique has been validated in a mock circulation; a single injection in diastole was further tested in porcine and ovine models. In the clinical setting, LVOT-AR was compared with trans-thoracic and trans-oesophageal echocardiography and cardiac magnetic resonance imaging. LVOT-AR > 17% discriminates mild from moderate aortic regurgitation on echocardiography and confers a poor prognosis in multiple registries, and justifies balloon post-dilatation. The LVOT-AR differentiates the individual performances of many old and novel devices and is being used in ongoing randomized trials and registries.
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