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Videodensitometric quantification of paravalvular regurgitation of a transcatheter aortic valve: in vitro validation
- Source :
- EuroIntervention, 13(13), 1527-1535. EuroPCR, ResearcherID
- Publication Year :
- 2018
-
Abstract
- Aims: Videodensitometric assessment of aortography provides a periprocedural quantitation of prosthetic valve regurgitation (PVR) after transcatheter aortic valve implantation. We sought to compare the videodensitometric parameters of PVR severity to the regurgitation fraction (RF) in a controlled in vitro setting. Methods and results: In a mock circulation system, a transcatheter balloon-expandable valve inserted at the aortic valve position was gradually deformed to induce different grades of paravalvular leakage and the RF was measured with a transonic flow probe. Contrast aortography was performed and the following videodensitometric parameters were generated: left ventricle aortic regurgitation (LV-AR), LV outflow tract AR (LVOT-AR), quantitative regurgitation assessment (qRA) index, relative maximum density (relative max), and maximum upslope of the LV time-density curve. The correlation was substantial between videodensitometric parameters (LV-AR, LVOT-AR, qRA index, relative max, and maximum upslope) and RF (r 2=0.96, 0.96, 0.93, 0.87, and 0.93; p2=0.99) with a mean difference of 1.92% (95% limits of agreement: ±2.83). The correlations of LV-AR and LVOT-AR with RF were stronger when more than one cardiac cycle was included in the analysis (one cycle: r 2=0.85 and r 2=0.83; four cycles: r 2=0.96 and r 2=0.96, for LV-AR and LVOT-AR, respectively). Including more cycles beyond four did not improve accuracy. Conclusions: Quantitative assessment of PVR by videodensitometry of aortograms strongly correlates with the actual RF in a controlled in vitro setting. Accuracy is improved by including more than one cardiac cycle in the analysis.
- Subjects :
- Models, Anatomic
Aortic valve
Hemodynamics
030204 cardiovascular system & hematology
Cardiovascular
Severity of Illness Index
0302 clinical medicine
Aortic Valve Insufficiency/diagnostic imaging
paravalvular leak
Models
Computer-Assisted/methods
030212 general & internal medicine
medicine.diagnostic_test
Cardiac cycle
transcatheter aortic valve implantation (TAVI)
Anatomic
Models, Cardiovascular
Radiographic Image Interpretation
medicine.anatomical_structure
Aortic Valve
Heart Valve Prosthesis
Cardiology
Radiographic Image Interpretation, Computer-Assisted
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Aortography
Heart Valve Prosthesis/adverse effects
Aortic Valve Insufficiency
Regurgitation (circulation)
Prosthesis Design
Transcatheter Aortic Valve Replacement
03 medical and health sciences
Region of interest
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted/methods
Internal medicine
medicine
Humans
imaging modalities
business.industry
aortic stenosis
Aortic Valve/diagnostic imaging
Ventricle
Transcatheter Aortic Valve Replacement/adverse effects
Aortography/methods
Densitometry
business
Subjects
Details
- Language :
- English
- ISSN :
- 1774024X
- Volume :
- 13
- Issue :
- 13
- Database :
- OpenAIRE
- Journal :
- EuroIntervention
- Accession number :
- edsair.doi.dedup.....fea634bf45d3be075c9ffa54b8138418