Bicuspid aortic valve sizing for transcatheter aortic valve implantation: Development and validation of an algorithm based on multi-slice computed tomography
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Bicuspid aortic valve sizing for transcatheter aortic valve implantation : Development and validation of an algorithm based on multi-slice computed tomography. / Petronio, Anna S.; Angelillis, Marco; De Backer, Ole; Giannini, Cristina; Costa, Giulia; Fiorina, Claudia; Castriota, Fausto; Bedogni, Francesco; Laborde, Jean C.; Søndergaard, Lars.
In: Journal of Cardiovascular Computed Tomography, Vol. 14, No. 5, 2020, p. 452-461.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Bicuspid aortic valve sizing for transcatheter aortic valve implantation
T2 - Development and validation of an algorithm based on multi-slice computed tomography
AU - Petronio, Anna S.
AU - Angelillis, Marco
AU - De Backer, Ole
AU - Giannini, Cristina
AU - Costa, Giulia
AU - Fiorina, Claudia
AU - Castriota, Fausto
AU - Bedogni, Francesco
AU - Laborde, Jean C.
AU - Søndergaard, Lars
PY - 2020
Y1 - 2020
N2 - Background: No indication are available for transcatheter aortic valve implantation (TAVI) sizing in bicuspid aortic valve (BAV). Aim of the study is to develop and validate a Multi-Slice Computed Tomography (MSCT)-based algorithm for transcatheter heart valve (THV) sizing in patients with stenotic BAV under evaluation for TAVI. Methods: A two steps method was applied: 1)evaluation of a cohort of 19 consecutive patients with type I BAV stenosis undergoing TAVI through pre and post-procedural MSCT, and development of an algorithm for THV sizing; 2)validation of the algorithm on a new cohort of 21 patients. Results: In the first cohort, a high correlation was found between the raphe-level area measured at pre-procedural MSCT and the smallest THV area measured at post-procedural MSCT (p < 0.001). Moreover, reduced THV expansion was observed among patients with higher calcium burden (p = 0.048). Then, a new algorithm for TAVI sizing in BAV was develop (CASPER: Calcium Algorithm Sizing for bicusPid Evaluation with Raphe). This algorithm is based on the reassessment of the perimeter/area derived annulus diameter, according to three main anatomical features: 1) the ratio between raphe length and annulus diameter; 2)calcium burden; 3)calcium distribution in relation to the raphe. The algorithm was then validated in a new cohort of 21 patients, achieving 100% of procedural success and excellent TAVI performance. Conclusion: MSCT assessment of raphe length, calcium burden and its distribution is of crucial relevance in the pre-procedural evaluation of patients with BAV. These anatomical features can be combined in a new and simple algorithm for TAVI sizing.
AB - Background: No indication are available for transcatheter aortic valve implantation (TAVI) sizing in bicuspid aortic valve (BAV). Aim of the study is to develop and validate a Multi-Slice Computed Tomography (MSCT)-based algorithm for transcatheter heart valve (THV) sizing in patients with stenotic BAV under evaluation for TAVI. Methods: A two steps method was applied: 1)evaluation of a cohort of 19 consecutive patients with type I BAV stenosis undergoing TAVI through pre and post-procedural MSCT, and development of an algorithm for THV sizing; 2)validation of the algorithm on a new cohort of 21 patients. Results: In the first cohort, a high correlation was found between the raphe-level area measured at pre-procedural MSCT and the smallest THV area measured at post-procedural MSCT (p < 0.001). Moreover, reduced THV expansion was observed among patients with higher calcium burden (p = 0.048). Then, a new algorithm for TAVI sizing in BAV was develop (CASPER: Calcium Algorithm Sizing for bicusPid Evaluation with Raphe). This algorithm is based on the reassessment of the perimeter/area derived annulus diameter, according to three main anatomical features: 1) the ratio between raphe length and annulus diameter; 2)calcium burden; 3)calcium distribution in relation to the raphe. The algorithm was then validated in a new cohort of 21 patients, achieving 100% of procedural success and excellent TAVI performance. Conclusion: MSCT assessment of raphe length, calcium burden and its distribution is of crucial relevance in the pre-procedural evaluation of patients with BAV. These anatomical features can be combined in a new and simple algorithm for TAVI sizing.
KW - Aortic stenosis
KW - Bicuspid aortic valve
KW - MSCT
KW - TAVI
U2 - 10.1016/j.jcct.2020.01.007
DO - 10.1016/j.jcct.2020.01.007
M3 - Journal article
C2 - 32001214
AN - SCOPUS:85078501328
VL - 14
SP - 452
EP - 461
JO - Journal of Cardiovascular Computed Tomography
JF - Journal of Cardiovascular Computed Tomography
SN - 1934-5925
IS - 5
ER -
ID: 260252739