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Do CTA measurements of annular diameter, perimeter and area result in different TAVI prosthesis sizes?

Incorrect prosthesis size has direct impact on patient outcome after transcatheter aortic valve implantation (TAVI) procedure. Currently, annular diameter, area or perimeter may be used for prosthesis size selection. The aim was to evaluate whether the use different annular dimensions would result i...

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Autores principales: Horehledova, Barbora, Mihl, Casper, Hendriks, Babs M. F., Eijsvoogel, Nienke G., Vainer, Jindrich, Veenstra, Leo F., Wildberger, Joachim E., Das, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208923/
https://www.ncbi.nlm.nih.gov/pubmed/29909590
http://dx.doi.org/10.1007/s10554-018-1394-1
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author Horehledova, Barbora
Mihl, Casper
Hendriks, Babs M. F.
Eijsvoogel, Nienke G.
Vainer, Jindrich
Veenstra, Leo F.
Wildberger, Joachim E.
Das, Marco
author_facet Horehledova, Barbora
Mihl, Casper
Hendriks, Babs M. F.
Eijsvoogel, Nienke G.
Vainer, Jindrich
Veenstra, Leo F.
Wildberger, Joachim E.
Das, Marco
author_sort Horehledova, Barbora
collection PubMed
description Incorrect prosthesis size has direct impact on patient outcome after transcatheter aortic valve implantation (TAVI) procedure. Currently, annular diameter, area or perimeter may be used for prosthesis size selection. The aim was to evaluate whether the use different annular dimensions would result in the selection of different prosthesis sizes, when assessed in the same TAVI-candidate during the same phase of a cardiac cycle. Fifty consecutive TAVI-candidates underwent retrospectively ECG-gated computed tomography angiography (CTA). Aortic root dimensions were assessed in the 20% phase of the R–R interval. Annular short diameter, perimeter and area were used to select the prosthesis size, based on the industry recommendations for a self-expandable (Medtronic CoreValve; MCV) and balloon-expandable (Edwards Sapien XT Valve; ESV) valve. Complete agreement on selected prosthesis size amongst all three annular dimensions was observed in 62% (31/50; ESV) and 30% (15/50; MCV). Short aortic annulus measurement resulted in a smaller prosthesis size in 20% (10/50; ESV) and in 60% of cases (30/50; MCV) compared to the size suggested by both annular perimeter and area. In 18% (9/50; ESV) and 10% of cases (5/50; MCV) a larger prosthesis would have been selected based on annular perimeter compared to annular diameter and area. Prosthesis size derived from area was always in agreement with at least one other parameter in all cases. Aortic annulus area appears to be the most robust parameter for TAVI-prosthesis size selection, regardless of the specific prosthesis size. Short aortic annulus diameter may underestimate the prosthesis size, while use of annular perimeter may lead to size overestimation in some cases.
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spelling pubmed-62089232018-11-09 Do CTA measurements of annular diameter, perimeter and area result in different TAVI prosthesis sizes? Horehledova, Barbora Mihl, Casper Hendriks, Babs M. F. Eijsvoogel, Nienke G. Vainer, Jindrich Veenstra, Leo F. Wildberger, Joachim E. Das, Marco Int J Cardiovasc Imaging Original Paper Incorrect prosthesis size has direct impact on patient outcome after transcatheter aortic valve implantation (TAVI) procedure. Currently, annular diameter, area or perimeter may be used for prosthesis size selection. The aim was to evaluate whether the use different annular dimensions would result in the selection of different prosthesis sizes, when assessed in the same TAVI-candidate during the same phase of a cardiac cycle. Fifty consecutive TAVI-candidates underwent retrospectively ECG-gated computed tomography angiography (CTA). Aortic root dimensions were assessed in the 20% phase of the R–R interval. Annular short diameter, perimeter and area were used to select the prosthesis size, based on the industry recommendations for a self-expandable (Medtronic CoreValve; MCV) and balloon-expandable (Edwards Sapien XT Valve; ESV) valve. Complete agreement on selected prosthesis size amongst all three annular dimensions was observed in 62% (31/50; ESV) and 30% (15/50; MCV). Short aortic annulus measurement resulted in a smaller prosthesis size in 20% (10/50; ESV) and in 60% of cases (30/50; MCV) compared to the size suggested by both annular perimeter and area. In 18% (9/50; ESV) and 10% of cases (5/50; MCV) a larger prosthesis would have been selected based on annular perimeter compared to annular diameter and area. Prosthesis size derived from area was always in agreement with at least one other parameter in all cases. Aortic annulus area appears to be the most robust parameter for TAVI-prosthesis size selection, regardless of the specific prosthesis size. Short aortic annulus diameter may underestimate the prosthesis size, while use of annular perimeter may lead to size overestimation in some cases. Springer Netherlands 2018-06-16 2018 /pmc/articles/PMC6208923/ /pubmed/29909590 http://dx.doi.org/10.1007/s10554-018-1394-1 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Paper
Horehledova, Barbora
Mihl, Casper
Hendriks, Babs M. F.
Eijsvoogel, Nienke G.
Vainer, Jindrich
Veenstra, Leo F.
Wildberger, Joachim E.
Das, Marco
Do CTA measurements of annular diameter, perimeter and area result in different TAVI prosthesis sizes?
title Do CTA measurements of annular diameter, perimeter and area result in different TAVI prosthesis sizes?
title_full Do CTA measurements of annular diameter, perimeter and area result in different TAVI prosthesis sizes?
title_fullStr Do CTA measurements of annular diameter, perimeter and area result in different TAVI prosthesis sizes?
title_full_unstemmed Do CTA measurements of annular diameter, perimeter and area result in different TAVI prosthesis sizes?
title_short Do CTA measurements of annular diameter, perimeter and area result in different TAVI prosthesis sizes?
title_sort do cta measurements of annular diameter, perimeter and area result in different tavi prosthesis sizes?
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208923/
https://www.ncbi.nlm.nih.gov/pubmed/29909590
http://dx.doi.org/10.1007/s10554-018-1394-1
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