MEDILEK, Karel, Josef BIS, Pavel POLANSKY, Tomas KVASNICKA, Alex BORG, Jaroslav DUSEK, Miroslav BRTKO, Martin TUNA, Rudolf PRAUS, Marek BALLON, Josef STASEK, Simona LITTNEROVÁ and 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, vol. 40, No 8, p. 784-791. ISSN 0742-2822. Available from: https://dx.doi.org/10.1111/echo.15643.
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Basic information
Original name Computed tomography is better than echocardiography in predicting balloon-expandable transcutaneous implantation valve size in a real-world clinical practice single-center study
Authors MEDILEK, Karel (203 Czech Republic, guarantor), Josef BIS (203 Czech Republic), Pavel POLANSKY (203 Czech Republic), Tomas KVASNICKA (203 Czech Republic), Alex BORG (203 Czech Republic), Jaroslav DUSEK (203 Czech Republic), Miroslav BRTKO (203 Czech Republic), Martin TUNA (203 Czech Republic), Rudolf PRAUS (203 Czech Republic), Marek BALLON (203 Czech Republic), Josef STASEK (203 Czech Republic), Simona LITTNEROVÁ (203 Czech Republic, belonging to the institution) and Petr PARIZEK (203 Czech Republic).
Edition Echocardiography - A Journal of Cardiovascular Ultrasound and Allied Techniques, Hoboken, Wiley, 2023, 0742-2822.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 1.500 in 2022
RIV identification code RIV/00216224:14110/23:00133370
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1111/echo.15643
UT WoS 001023676300001
Keywords in English 3D echocardiography; annulus sizing; multidetector computed tomography; Sapien valve; TAVR
Tags 14119612, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 1/2/2024 10:23.
Abstract
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.
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