Aortic annulus eccentricity before and after transcatheter aortic valve implantation: Comparison of balloon-expandable and self-expanding prostheses

作者：Schuhbaeck Annika^*; Weingartner Christina; Arnold Martin; Schmid Jasmin; Pflederer Tobias; Marwan Mohamed; Rixe Johannes; Nef Holger; Schneider Christian; Lell Michael; Uder Michael; Ensminger Stephan; Feyrer Richard; Weyand Michael; Achenbach Stephan

来源：European Journal of Radiology, 2015, 84(7): 1242-1248.

DOI：10.1016/j.ejrad.2015.04.003

• Aortic valve stenosis
• Heart valve prosthesis implantation
• Multidetector computed tomography
• Cardiac imaging techniques
• Three-dimensional imaging of the aortic root

Introduction: The geometry of the aortic annulus and implanted transcatheter aortic valve prosthesis might influence valve function. We investigated the influence of valve type and aortic valve calcification on post-implant geometry of catheter-based aortic valve prostheses.
Methods: Eighty consecutive patients with severe aortic valve stenosis (mean age 82 +/- 6 years) underwent computed tomography before and after TAVI. Aortic annulus diameters were determined. Influence of prosthesis type and degree of aortic valve calcification on post-implant eccentricity were analysed.
Results: Aortic annulus eccentricity was reduced in patients after TAVI (0.21 +/- 0.06 vs. 0.08 +/- 0.06, p < 0.0001). Post-TAVI eccentricity was significantly lower in 65 patients following implantation of a balloon-expandable prosthesis as compared to 15 patients who received a self-expanding prosthesis (0.06 +/- 0.05 vs. 0.15 +/- 0.07, p < 0.0001), even though the extent of aortic valve calcification was not different. After TAVI, patients with a higher calcium amount retained a significantly higher eccentricity compared to patients with lower amounts of calcium.
Conclusions: Patients undergoing TAVI with a balloon-expandable prosthesis show a more circular shape of the implanted prosthesis as compared to patients with a self-expanding prosthesis. Eccentricity of the deployed prosthesis is affected by the extent of aortic valve calcification.

• 出版日期2015-7