COMPUTED TOMOGRAPHY IN THE EVALUATION OF EARLY POSTOPERATIVE
COMPLICATIONS AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT
Veselova T.N.¹, Shirkin A.V.¹, Ternovoy S.K.¹,², Imaev T.E.¹, Syrkhaeva A.A.¹
1 – E.I. Chazov National Medical Research Centre of Cardiology.
2 – Sechenov University. Moscow, Russia.
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urpose. To study the correlation between computed tomographic (CT) characteristics of the aortic root anatomy and the progression of postoperative complications associated with the prosthesis condition in patients undergoing transcatheter aortic valve implantation (TAVI) for critical aortic stenosis.
Methods. We examined 70 patients aged 60 to 91 years old with a verified diagnosis of critical aortic valve stenosis. All patients had preoperative CT aortography on a Canon Aquilion ONE CT scanner with 640 slices and a 160 mm wide detector. We analyzed parameters such as fibrous ring shape, degree of aortic valve calcinosis, symmetry of aortic valve calcinosis, number of aortic valve leaflets, distance from coronary artery ostia to fibrous ring, aortic-ventricular angle and severity of aortic atheromatosis. Control transthoracic echocardiography (EchoCG) was performed in all patients on day 1-3 after TAVI to analyze the condition of the prosthesis and identify potential postoperative complications.
Results. A mild correlation between the severity of asymmetry of aortic valve calcinosis and the degree of paraprosthetic regurgitation was observed in the total patient group (r=0.44, p=0.0002) and in the CoreValve Evolut group (r=0.40, p<0.015). This correlation was more pronounced in the Acurate Neo group (r=0.52, p=0.002). The degree of aortic valve calcinosis weakly but significantly correlated with the degree of paraprosthetic regurgitation in the overall patient group (r=0.34, p=0.0004). This correlation was more pronounced in the CoreValve Evolut group (r=0.44, p=0.006) and was not significant in the Acurate Neo group. There was no statistically significant correlation between paraprosthetic regurgitation and the other CT criteria.
Conclusion. Asymmetric calcification of the aortic valve and, to a lesser extent, the severity of calcinosis can serve as prognostic factors of paraprosthetic regurgitation after TAVI using Acurate Neo and CoreVale self-expanding prostheses.
Keywords: computed tomography, transcatheter aortic valve implantation, aortic valve stenosis, hybrid technology in surgery.
Corresponding author: Shirkin A.V., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Veselova T.N., Shirkin A.V., Ternovoy S.K., Imaev T.E., Syrkhaeva A.A. Computed tomography in the evaluation of early postoperative сomplications after transcatheter aortic valve replacement. REJR 2023; 13(2):75-82. DOI: 10.21569/2222-7415-2023-13-2-75-82.
Received: 15.01.23 Accepted: 22.02.23