Aortic Valve Calcium Volume Predicts Paravalvular Regurgitation and the Need for Balloon Post‐Dilatation After Transcatheter Aortic Valve Implantation

Abstract

AV calcium volume was an independent predictor of PVR and BPD in patients submitted to TAVI. Our results support a systematic assessment of AV calcium volume to identify patients at increased risk of post-procedural PVR.

Practical determination of aortic valve calcium volume score on contrast-enhanced computed tomography prior to transcatheter aortic valve replacement and impact on paravalvular regurgitation: Elucidating optimal threshold cutoffs

“…The authors did not, however, study varied cutoffs relative to luminal attenuation. Similar results were found by Fonseca et al 28 In contrast to the study by these authors, the current study shows in general a stronger predictive value of algorithms using threshold cutoffs relative to luminal attenuation than for fixed threshold protocols. Furthermore, the protocol using luminal attenuation + 100 HU suggests the highest predictive value of protocols studied with an optimal calcium volume cutoff of approximately 1200 mm 3 , despite having a similar or lower average threshold cutoff value than other studied protocols.…”

Comparison of self‐expanding and balloon‐expandable transcatheter aortic valves morphology and association with paravalvular regurgitation: Evaluation using multidetector computed tomography

“…Those patients had greater eccentricity and underexpansion compared to individuals with none/trace PVR. As expected, the volume of calcium was an independent predictor of PVR . However, independently of the type and model of valve or calcium volume, eccentricity index also was an independent predictor of PVR.…”

“…Quantification of the aortic valve complex (from annulus plane to the leaflet tips) and left ventricle outflow tract (LVOT) (until 5 mm below the annular plane) calcium volume was performed with a threshold of 850 HU ( Figure 1B). This threshold was shown to have the greatest discriminatory value for mild PVR in a previous study from our center [13]. Landing zone calcium volume included aortic valve complex and LVOT.…”

Postdilatation ballooning of an Edwards ELITE rapid deployment bioprosthesis for a severe paravalvular leak

“…Postdilatation ballooning is a known procedure in the setting of TAVR, but has not been performed on a rapid deployment prosthesis.…”

“…The incidence of paravalvular leak in the sutureless valve population is between 5% and 15%. 3 Postdilatation ballooning is a known procedure in the setting of TAVR, 4 but has not been performed on a rapid deployment prosthesis.…”