Aortic regurgitation after transcatheter aortic valve implantation (TAVI) - Angiographic, echocardiographic and hemodynamic assessment in relation to one year outcome

被引:12
作者
Collas, Valerie M. [1 ,2 ]
Paelinck, Bernard P. [3 ]
Rodrigus, Inez E. [3 ]
Vrints, Christiaan J. [1 ,2 ]
Bosmans, Johan M. [1 ,2 ]
机构
[1] Univ Antwerp, Fac Med & Hlth Sci, Dept Translat Pathophysiol Res, Cardiovasc Dis, B-2610 Antwerp, Belgium
[2] Univ Antwerp Hosp, Dept Cardiol, B-2650 Edegem, Belgium
[3] Univ Antwerp Hosp, Dept Cardiac Surg, B-2650 Edegem, Belgium
关键词
Aortic valve stenosis; Transcatheter aortic valve implantation; Aortic regurgitation; Paravalvular leakage; END-POINT DEFINITIONS; PARAVALVULAR REGURGITATION; DOPPLER-ECHOCARDIOGRAPHY; REPLACEMENT; PREDICTORS; RECOMMENDATIONS; QUANTIFICATION; MECHANISMS; MANAGEMENT; STENOSIS;
D O I
10.1016/j.ijcard.2015.05.015
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) remains a relatively frequent and life-limiting complication. However, the most prognostically discriminative (and therefore preferred) technique of AR evaluation after TAVI is not yet clearly defined. The aim of this study was to compare angiographic, echocardiographic and hemodynamic assessment of AR after TAVI in relation to one year outcome. Methods and results: In this single center prospective cohort study, angiography (AR grading), echocardiography (AR quantification using color Doppler flow mapping) and invasive hemodynamics (AR index) were assessed before and after TAVI. All patients were followed up to at least one year. A total of 111 consecutive (very) high-risk patients with severe, symptomatic aortic valve stenosis underwent TAVI. No concordant relation could be demonstrated between angiographic, echocardiographic and invasive assessment of AR after TAVI. AR index <25 post TAVI was significantly influenced by left ventricular posterior wall thickness (odds ratio: 1.276, p = 0.030) and AR index pre TAVI (odds ratio: 0.948, p = 0.019). Neither angiographic nor hemodynamic AR assessments were able to discriminate between good or significantly decreased one year survival. In contrast, color Doppler flow mapping of AR after TAVI was highly reproducible, and able to differentiate between good or significantly decreased one year survival (AR grades 0-I: one year survival 87% vs. AR grades II-III-IV: one year survival 68%, p = 0.035). Conclusion: Echocardiography using color Doppler flow mapping is the preferred technique to assess prognostically relevant AR after TAVI. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:13 / 20
页数:8
相关论文
共 28 条
[1]   Comparison of Two- and Three-Dimensional Transthoracic Echocardiography to Cardiac Magnetic Resonance Imaging for Assessment of Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation [J].
Altiok, Ertunc ;
Frick, Michael ;
Meyer, Christian G. ;
Al Ateah, Ghazi ;
Napp, Andreas ;
Kirschfink, Annemarie ;
Almalla, Mohammad ;
Lotfi, Shahran ;
Becker, Michael ;
Herich, Lena ;
Lehmacher, Walter ;
Hoffmann, Rainer .
AMERICAN JOURNAL OF CARDIOLOGY, 2014, 113 (11) :1859-1866
[2]   Incidence, Predictors, and Outcomes of Aortic Regurgitation After Transcatheter Aortic Valve Replacement Meta-Analysis and Systematic Review of Literature [J].
Athappan, Ganesh ;
Patvardhan, Eshan ;
Tuzcu, E. Murat ;
Svensson, Lars Georg ;
Lemos, Pedro A. ;
Fraccaro, Chiara ;
Tarantini, Giuseppe ;
Sinning, Jan-Malte ;
Nickenig, Georg ;
Capodanno, Davide ;
Tamburino, Corrado ;
Latib, Azeem ;
Colombo, Antonio ;
Kapadia, Samir R. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2013, 61 (15) :1585-1595
[3]  
Evangelista A, 2000, AM HEART J, V139, P773
[4]   Mechanisms and management of TAVR-related complications [J].
Fassa, Amir-Ali ;
Himbert, Dominique ;
Vahanian, Alec .
NATURE REVIEWS CARDIOLOGY, 2013, 10 (12) :685-695
[5]   Paravalvular Leak After Transcatheter Aortic Valve Replacement The New Achilles' Heel? A Comprehensive Review of the Literature [J].
Genereux, Philippe ;
Head, Stuart J. ;
Hahn, Rebecca ;
Daneault, Benoit ;
Kodali, Susheel ;
Williams, Mathew R. ;
van Mieghem, Nicolas M. ;
Alu, Maria C. ;
Serruys, Patrick W. ;
Kappetein, A. Pieter ;
Leon, Martin B. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2013, 61 (11) :1125-1136
[6]   Three-Dimensional Echocardiography in Paravalvular Aortic Regurgitation Assessment after Transcatheter Aortic Valve Implantation [J].
Goncalves, Alexandra ;
Almeria, Carlos ;
Marcos-Alberca, Pedro ;
Feltes, Gisela ;
Hernandez-Antolin, Rosana ;
Rodriguez, Enrique ;
Silva Cardoso, Jose C. ;
Macaya, Carlos ;
Luis Zamorano, Jose .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2012, 25 (01) :47-55
[7]   Intraoperative 2D and 3D transoesophageal echocardiographic predictors of aortic regurgitation after transcatheter aortic valve implantation [J].
Gripari, Paola ;
Ewe, See Hooi ;
Fusini, Laura ;
Muratori, Manuela ;
Ng, Arnold C. T. ;
Cefalu, Claudia ;
Delgado, Victoria ;
Schalij, Martin J. ;
Bax, Jeroen J. ;
Marsan, Nina Ajmone ;
Tamborini, Gloria ;
Pepi, Mauro .
HEART, 2012, 98 (16) :1229-1236
[8]   Paravalvular Regurgitation Following Transcutaneous Aortic Valve Replacement: Predictors and Clinical Significance [J].
Hahn, Rebecca T. ;
Kodali, Susheel ;
Genereux, Philippe ;
Leon, Martin .
CURRENT CARDIOLOGY REPORTS, 2014, 16 (05)
[9]   Decision-making in elderly patients with severe aortic stenosis:: why are so many denied surgery? [J].
Iung, B ;
Cachier, A ;
Baron, G ;
Messika-Zeitoun, D ;
Delahaye, F ;
Tornos, P ;
Gohlke-Bärwolf, C ;
Boersma, E ;
Ravaud, P ;
Vahanian, A .
EUROPEAN HEART JOURNAL, 2005, 26 (24) :2714-2720
[10]   Contemporary Application of Cardiovascular Hemodynamics: Transcatheter Aortic Valve Interventions [J].
Jilaihawi, Hasan ;
Kar, Saibal ;
Doctor, Niraj ;
Fontana, Gregory ;
Makkar, Raj .
CARDIOLOGY CLINICS, 2011, 29 (02) :211-+