Immediate and Long-Term Echocardiographic Findings after Transcatheter Aortic Valve Implantation for the Treatment of Aortic Stenosis: The Cribier-Edwards/Edwards-Sapien Valve Experience

被引:36
作者
Bauer, Fabrice [1 ,2 ]
Lemercier, Mathieu [1 ]
Zajarias, Alan
Tron, Christophe
Eltchaninoff, Helene
Cribier, Alain [1 ,2 ]
机构
[1] Rouen Univ Hosp, Div Cardiol, Rouen, France
[2] INSERM, U644, Rouen Med Sch, Res Lab, Rouen, France
关键词
Aortic stenosis; Doppler; Prosthesis; Surgery; Transcatheter heart valve implantation; PERCUTANEOUS BALLOON VALVULOPLASTY; PROSTHETIC HEART-VALVE; FOLLOW-UP; REPLACEMENT; REGURGITATION; IMPROVEMENT; IMPACT;
D O I
10.1016/j.echo.2010.01.020
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The role of transcatheter aortic valve implantation in the treatment of calcific aortic stenosis is evolving. Immediate and long-term echocardiographic findings are poorly reported. Methods: Eighty-eight patients in whom surgical aortic valve replacement was contraindicated were studied before and 1 and 7 days, 1 month, and 1 and 2 years after the transcatheter procedure by echocardiography for hemodynamic. Transaortic pressure gradient, permeability index, and aortic valve area were measured, and aortic regurgitation was estimated from a multiparametric approach. A subset group of 36 patients (23-mm valve, n = 18; 26-mm valve, n = 18) with optimal ultrasound window were investigated for valve geometry at 7 days. We measured the sphericity index (anteroposterior to sagittal diameter ratio) and the angulation of the prosthesis with the ascending aorta. Results: By analysis of variance, transaortic pressure gradient significantly decreased and aortic valve area increased after the procedure (P < .0001 and P < .0001 respectively). Aortic regurgitation severity tended to decline at follow-up (P = .20) and was unaffected by valve size (P = .35). Leaks were paraprosthetic in 77% of cases, intraprosthetic in 6% of cases, and both in 17% of cases. Overall, the sphericity index was 1.03 +/- 0.07 and the angulation was 2.9 +/- 1.1 degrees. Conclusion: Echocardiography aids in the demonstration of appropriate prosthesis function and positioning after transcatheter aortic valve implantation. (J Am Soc Echocardiogr 2010;23:370-6.)
引用
收藏
页码:370 / 376
页数:7
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