An objective and reproducible method for quantification of aortic regurgitation after TAVI

Schultz, Carl; Slots, Tristan; Yong, Gerald; Aben, Jean‐Paul; Mieghem, Nicolas Van; Swaans, Martin J.; Rahhab, Zouhair; Faquir, Nahid El; Geuns, Robert van; Mast, Gijs; Zijlstra, Felix; Jaegere, Peter P.T. de

doi:10.4244/eijy14m05_06

Cited by 41 publications

(31 citation statements)

References 17 publications

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“…Final angiographic image acquisition was done ≥10 min after transcatheter heart valve (THV) implantation or final postdilatation. The planned angiographic image acquisition protocol to improve the feasibility for VD analysis requires that (1) image acquisition of fluoroscopy is recorded ≥2 heart beats prior to the contrast injection and for 3-5 beats during the contrast injection and a minimum of 30 cine-fluoroscopic been evaluated.…”

Section: Angiography Protocolmentioning

confidence: 99%

“…1 Therefore, the second software generation focused on the LV outflow tract AR (LVOT-AR) as the ROI, in order to improve the feasibility of the assessment. 2 Over the past 2 years, the precision and accuracy of the method have been validated in vitro, compared clinically with other methods of assessment such as echocardiography and magnetic resonance imaging (MRI), and evaluated from a prognostic point of view.…”

mentioning

confidence: 99%

“…Using dedicated contrastvideodensitometry (VD) software, Schultz et al reported an objective and reproducible method to assess the severity of AR after TAVI. 1 Given that the first generation of the software assessed the entire left ventricle (LV) as a region tion and planning of angiographic image acquisition (including identification of the optimal angiographic view before TAVI) are needed. Recently Teng et al reported a method to identify overlap-free projection on fluoroscopy.…”

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confidence: 99%

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Role of Computed Tomography in Planning the Appropriate X-Ray Gantry for Quantitative Aortography of Post-transcatheter Aortic Valve Implantation Regurgitation

Tateishi

Miyazaki

Okamura

et al. 2018

Circ J

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Background:The clinical robustness of contrast-videodensitometric (VD) assessment of aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) has been demonstrated. Correct acquisition of aortic root angiography for VD assessment, however, is hampered by the opacified descending aorta and by individual anatomic peculiarities. The aim of this study was to use preprocedural multi-slice computed tomography (MSCT) to optimize the angiographic projection in order to improve the feasibility of VD assessment. Methods and Results:In 92 consecutive patients, post-TAVI AR (i.e., left ventricular outflow tract [LVOT] AR) was assessed on aortic root angiograms using VD software. The patients were divided into 2 groups: The first group of 54 patients was investigated prior to the introduction of the standardized acquisition protocol; the second group of 38 consecutive patients after implementation of the standardized acquisition protocol, involving MSCT planning of the optimal angiographic projection. Optimal projection planning has dramatically improved the feasibility of VD assessment from 57.4% prior to the standardized acquisition protocol, to 100% after the protocol was implemented. In 69 analyzable aortograms (69/92; 75%), LVOT-AR ranged from 3% to 28% with a median of 12%. Inter-observer agreement was high (mean difference±SD, 1±2%), and the 2 observers' measurements were highly correlated (r=0.94, P<0.0001). Conclusions:Introduction of computed tomography-guided angiographic image acquisition has significantly improved the analyzability of the angiographic VD assessment of post-TAVI AR.

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Section: Angiography Protocolmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Role of Computed Tomography in Planning the Appropriate X-Ray Gantry for Quantitative Aortography of Post-transcatheter Aortic Valve Implantation Regurgitation

Tateishi

Miyazaki

Okamura

et al. 2018

Circ J

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“…The details of this technique have been described elsewhere. 12 - 14 , 16 , 18 After drawing the contours of the aortic root ( i.e . reference region) and the subaortic one third of the left ventricle (i.e.…”

Section: Methodsmentioning

confidence: 99%

The Role of Quantitative Aortographic Assessment of Aortic Regurgitation by Videodensitometry in the Guidance of Transcatheter Aortic Valve Implantation

Miyazaki¹,

Modolo²,

Abdelghani³

et al. 2018

Arquivos Brasileiros De Cardiologia

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BackgroundBalloon post-dilatation (BPD) is often needed for optimizing transcatheter heart valve (THV) implantation, since paravalvular leak (PVL) after transcatheter aortic valve implantation is associated with poor outcome and mortality. Quantitative assessment of PVL severity before and after BPD is mandatory to properly assess PVL, thus improving implantation results and outcomes.ObjectiveTo investigate a quantitative angiographic assessment of aortic regurgitation (AR) by videodensitometry before and after BPD.MethodsVideodensitometric-AR assessments (VD-AR) before and after BPD were analysed in 61 cases.ResultsVD-AR decreased significantly from 24.0[18.0-30.5]% to 12.0[5.5-19.0]% (p < 0.001, a two-tailed p < 0.05 defined the statistical significance). The relative delta of VD-AR after BPD ranged from -100% (improvement) to +40% (deterioration) and its median value was -46.2%. The frequency of improvement, no change, and deterioration were 70% (n = 43), 25% (n = 15) and 5% (n = 3), respectively. Significant AR (VD-AR > 17%) was observed in 47 patients (77%) before and in 19 patients (31%) after BPD.ConclusionsVD-AR after THV implantation provides a quantitative assessment of post-TAVI regurgitation and can help in the decision-making process on performing BPD and in determining its efficacy.

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“…23 Schultz and colleagues 23 used a proprietary software tool to generate timedensity curves in specified areas of the angiographic image (Fig. 1A).…”

Section: Cineangiographic Assessmentmentioning

confidence: 99%

Assessment of Paravalvular Regurgitation Following Transcatheter Aortic Valve Replacement

Hahn

2015

Interventional Cardiology Clinics

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An objective and reproducible method for quantification of aortic regurgitation after TAVI

Abstract: Quantification of aortic regurgitation by measurement of time-density changes on contrast aortography may improve the reproducibility of AR assessment in the catheter laboratory. Steps for standardised aortography acquisition are proposed.

Cited by 41 publications

References 17 publications

Role of Computed Tomography in Planning the Appropriate X-Ray Gantry for Quantitative Aortography of Post-transcatheter Aortic Valve Implantation Regurgitation

Role of Computed Tomography in Planning the Appropriate X-Ray Gantry for Quantitative Aortography of Post-transcatheter Aortic Valve Implantation Regurgitation

The Role of Quantitative Aortographic Assessment of Aortic Regurgitation by Videodensitometry in the Guidance of Transcatheter Aortic Valve Implantation

Assessment of Paravalvular Regurgitation Following Transcatheter Aortic Valve Replacement

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