Abdelshafy, Mahmoud;
Serruys, Patrick W;
Tsai, Tsung-Ying;
Revaiah, Pruthvi Chenniganahosahalli;
Garg, Scot;
Aben, Jean-Paul;
Schultz, Carl J;
... Onuma, Yoshinobu; + view all
(2023)
Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement.
Frontiers in Cardiovascular Medicine
, 10
, Article 1161779. 10.3389/fcvm.2023.1161779.
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Abstract
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.
| Type: | Article |
|---|---|
| Title: | Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement |
| Location: | Switzerland |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fcvm.2023.1161779 |
| Publisher version: | https://doi.org/10.3389/fcvm.2023.1161779 |
| Language: | English |
| Additional information: | © 2023 Abdelshafy, Serruys, Tsai, Revaiah, Grag, Aben, Schultz, Abdelghani, Tonino, Miyazaki, Rutten, Cox, Sahyoun, Teng, Tateishi, AbdelWahab, Piazza, Pighi, Modolo, van Mourik, Wykrzykowska, de Wintet, Lemos, de Brito, Kawashima, Søendergaard, Rosseel, Wang, Gao, Tao, Rück, Kim, van Royen, Terkelsen, Nissen, Adam, Rudolph, Wienemann, Torii, Neuman, Schoechlin, Chen, Elkoumy, Elzomor, AmatSantos, Mylotte, Soliman and Onuma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. https://creativecommons.org/licenses/by/4.0/ |
| Keywords: | aortic regurgitation, paravalvular leak, videodensitometry, transcatheter aortic valve replacement, transcatheter aortic valve implantation, quantitative aortography |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10174775 |
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