Computed tomography is better than echocardiography in
predicting balloon-expandable transcutaneous implantation valve
size in a real-world clinical practice single-center study

J 2023

Computed tomography is better than echocardiography in predicting balloon-expandable transcutaneous implantation valve size in a real-world clinical practice single-center study

MEDILEK, Karel, Josef BIS, Pavel POLANSKY, Tomas KVASNICKA, Alex BORG et. al.

Základní údaje

Originální název

Computed tomography is better than echocardiography in predicting balloon-expandable transcutaneous implantation valve size in a real-world clinical practice single-center study

Autoři

MEDILEK, Karel (203 Česká republika, garant), Josef BIS (203 Česká republika), Pavel POLANSKY (203 Česká republika), Tomas KVASNICKA (203 Česká republika), Alex BORG (203 Česká republika), Jaroslav DUSEK (203 Česká republika), Miroslav BRTKO (203 Česká republika), Martin TUNA (203 Česká republika), Rudolf PRAUS (203 Česká republika), Marek BALLON (203 Česká republika), Josef STASEK (203 Česká republika), Simona LITTNEROVÁ (203 Česká republika, domácí) a Petr PARIZEK (203 Česká republika)

Vydání

Echocardiography - A Journal of Cardiovascular Ultrasound and Allied Techniques, Hoboken, Wiley, 2023, 0742-2822

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 1.500 v roce 2022

Kód RIV

RIV/00216224:14110/23:00133370

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1111/echo.15643

UT WoS

001023676300001

Klíčová slova anglicky

3D echocardiography; annulus sizing; multidetector computed tomography; Sapien valve; TAVR

Štítky

14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 1. 2. 2024 10:23, Mgr. Tereza Miškechová

Anotace

V originále

AimsTranscatheter aortic valve replacement (TAVR) has become the standard of care for selected patients with severe aortic stenosis. Multidetector computed tomography (MDCT) and transoesophageal 2D/3D (two-dimensional/three-dimensional) echocardiography (ECHO) are used for aortic annulus (AA) sizing. The aim of this study was to compare the accuracy of AA sizing by ECHO versus MDCT for Edwards Sapien balloon expandable valve in a single center. Methods and resultsData from 145 consecutive patients with TAVR (Sapien XT or Sapien S3) were analyzed retrospectively. A total of 139 (96%) patients had favorable outcomes after TAVR (at most mild aortic regurgitation and only one valve implanted). The 3D ECHO AA area and area-derived diameter were smaller than the corresponding MDCT parameters (464 & PLUSMN; 99 vs. 479 & PLUSMN; 88 mm(2), p < .001, and 24.2 & PLUSMN; 2.7 vs. 25.0 & PLUSMN; 5.5 mm, p = .002, respectively). The 2D ECHO annulus measurement was smaller than both the MDCT and 3D ECHO area-derived diameters (22.6 & PLUSMN; 2.9 vs. 25.0 & PLUSMN; 5.5 mm, p = .013, and 22.6 & PLUSMN; 2.9 vs. 24.2 & PLUSMN; 2.7 mm, p < .001, respectively) but larger than the minor axis diameter of the AA derived from MDCT and 3D ECHO by multiplanar reconstruction (p < .001). The 3D ECHO circumference-derived diameter was also smaller than the MDCT circumference-derived diameter (24.3 & PLUSMN; 2.5 vs. 25.0 & PLUSMN; 2.3, p = .007). The sphericity index by 3D ECHO was smaller than that by MDCT (1.2 & PLUSMN; .1 vs. 1.3 & PLUSMN; .1, p < .001). In up to 1/3 of the patients, 3D ECHO measurements would have predicted different (generally smaller) valve size than was the valve size implanted with favorable result. The concordance of the implanted valve size with the recommended size based on preprocedural MDCT and 3D ECHO AA area was 79.4% versus 61% (p = .001), and for the area-derived diameter, the concordance was 80.1% versus 61.7% (p = .001). 2D ECHO diameter concordance was similar to MDCT (78.7%); however, MDCT AA area derived diameter extrapolated from 2D ECHO measurement would have led to the different valve size selection in additional 33% of the patients. Conclusions3D ECHO AA measurements are smaller than MDCT measurements. If 3D ECHO-based parameters alone are used to size the Edwards Sapien balloon expandable valve, then the selected valve size would have been smaller than the valve size implanted with favorable result in 1/3 of the patients. MDCT preprocedural TAVR assessment should be the preferred method over 3D ECHO in routine clinical practice to determine Edwards Sapien valve size.

Citovat

MEDILEK, Karel, Josef BIS, Pavel POLANSKY, Tomas KVASNICKA, Alex BORG, Jaroslav DUSEK, Miroslav BRTKO, Martin TUNA, Rudolf PRAUS, Marek BALLON, Josef STASEK, Simona LITTNEROVÁ a Petr PARIZEK. Computed tomography is better than echocardiography in predicting balloon-expandable transcutaneous implantation valve size in a real-world clinical practice single-center study. Echocardiography - A Journal of Cardiovascular Ultrasound and Allied Techniques. Hoboken: Wiley, 2023, roč. 40, č. 8, s. 784-791. ISSN 0742-2822. Dostupné z: https://dx.doi.org/10.1111/echo.15643.

@article{2368539,
   author = {Medilek, Karel and Bis, Josef and Polansky, Pavel and Kvasnicka, Tomas and Borg, Alex and Dusek, Jaroslav and Brtko, Miroslav and Tuna, Martin and Praus, Rudolf and Ballon, Marek and Stasek, Josef and Littnerová, Simona and Parizek, Petr},
   article_location = {Hoboken},
   article_number = {8},
   doi = {http://dx.doi.org/10.1111/echo.15643},
   keywords = {3D echocardiography; annulus sizing; multidetector computed tomography; Sapien valve; TAVR},
   language = {eng},
   issn = {0742-2822},
   journal = {Echocardiography - A Journal of Cardiovascular Ultrasound and Allied Techniques},
   title = {Computed tomography is better than echocardiography in predicting balloon-expandable transcutaneous implantation valve size in a real-world clinical practice single-center study},
   url = {https://onlinelibrary.wiley.com/doi/10.1111/echo.15643},
   volume = {40},
   year = {2023}
}

TY  - JOUR
ID  - 2368539
AU  - Medilek, Karel - Bis, Josef - Polansky, Pavel - Kvasnicka, Tomas - Borg, Alex - Dusek, Jaroslav - Brtko, Miroslav - Tuna, Martin - Praus, Rudolf - Ballon, Marek - Stasek, Josef - Littnerová, Simona - Parizek, Petr
PY  - 2023
TI  - Computed tomography is better than echocardiography in predicting balloon-expandable transcutaneous implantation valve size in a real-world clinical practice single-center study
JF  - Echocardiography - A Journal of Cardiovascular Ultrasound and Allied Techniques
VL  - 40
IS  - 8
SP  - 784-791
EP  - 784-791
PB  - Wiley
SN  - 07422822
KW  - 3D echocardiography
KW  - annulus sizing
KW  - multidetector computed tomography
KW  - Sapien valve
KW  - TAVR
UR  - https://onlinelibrary.wiley.com/doi/10.1111/echo.15643
N2  - AimsTranscatheter aortic valve replacement (TAVR) has become the standard of care for selected patients with severe aortic stenosis. Multidetector computed tomography (MDCT) and transoesophageal 2D/3D (two-dimensional/three-dimensional) echocardiography (ECHO) are used for aortic annulus (AA) sizing. The aim of this study was to compare the accuracy of AA sizing by ECHO versus MDCT for Edwards Sapien balloon expandable valve in a single center. Methods and resultsData from 145 consecutive patients with TAVR (Sapien XT or Sapien S3) were analyzed retrospectively. A total of 139 (96%) patients had favorable outcomes after TAVR (at most mild aortic regurgitation and only one valve implanted). The 3D ECHO AA area and area-derived diameter were smaller than the corresponding MDCT parameters (464 & PLUSMN; 99 vs. 479 & PLUSMN; 88 mm(2), p < .001, and 24.2 & PLUSMN; 2.7 vs. 25.0 & PLUSMN; 5.5 mm, p = .002, respectively). The 2D ECHO annulus measurement was smaller than both the MDCT and 3D ECHO area-derived diameters (22.6 & PLUSMN; 2.9 vs. 25.0 & PLUSMN; 5.5 mm, p = .013, and 22.6 & PLUSMN; 2.9 vs. 24.2 & PLUSMN; 2.7 mm, p < .001, respectively) but larger than the minor axis diameter of the AA derived from MDCT and 3D ECHO by multiplanar reconstruction (p < .001). The 3D ECHO circumference-derived diameter was also smaller than the MDCT circumference-derived diameter (24.3 & PLUSMN; 2.5 vs. 25.0 & PLUSMN; 2.3, p = .007). The sphericity index by 3D ECHO was smaller than that by MDCT (1.2 & PLUSMN; .1 vs. 1.3 & PLUSMN; .1, p < .001). In up to 1/3 of the patients, 3D ECHO measurements would have predicted different (generally smaller) valve size than was the valve size implanted with favorable result. The concordance of the implanted valve size with the recommended size based on preprocedural MDCT and 3D ECHO AA area was 79.4% versus 61% (p = .001), and for the area-derived diameter, the concordance was 80.1% versus 61.7% (p = .001). 2D ECHO diameter concordance was similar to MDCT (78.7%); however, MDCT AA area derived diameter extrapolated from 2D ECHO measurement would have led to the different valve size selection in additional 33% of the patients. Conclusions3D ECHO AA measurements are smaller than MDCT measurements. If 3D ECHO-based parameters alone are used to size the Edwards Sapien balloon expandable valve, then the selected valve size would have been smaller than the valve size implanted with favorable result in 1/3 of the patients. MDCT preprocedural TAVR assessment should be the preferred method over 3D ECHO in routine clinical practice to determine Edwards Sapien valve size.
ER  -

MEDILEK, Karel, Josef BIS, Pavel POLANSKY, Tomas KVASNICKA, Alex BORG, Jaroslav DUSEK, Miroslav BRTKO, Martin TUNA, Rudolf PRAUS, Marek BALLON, Josef STASEK, Simona LITTNEROVÁ a Petr PARIZEK. Computed tomography is better than echocardiography in predicting balloon-expandable transcutaneous implantation valve size in a real-world clinical practice single-center study. \textit{Echocardiography - A Journal of Cardiovascular Ultrasound and Allied Techniques}. Hoboken: Wiley, 2023, roč.~40, č.~8, s.~784-791. ISSN~0742-2822. Dostupné z: https://dx.doi.org/10.1111/echo.15643.

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