Quantitative aortography for assessing aortic regurgitation after transcatheter aortic valve implantation: results of the multicentre ASSESS-REGURGE Registry

Author(s):Show less -

Modolo, Rodrigo ^{[1, 2]} ; Chang, Chun Chin ^[3] ; Tateishi, Hiroki ^[4] ; Miyazaki, Yosuke ^{[3, 4]} ; Pighi, Michele ^[5] ; Abdelghani, Mohammad ^{[1, 6]} ; Roos, Martin A. ^[3] ; Wolff, Quinten ^[3] ; Wykrzykowska, Joanna J. ^[1] ; de Winter, Robbert ^[1] ; Piazza, Nicolo ^[5] ; Richardt, Gert ^[6] ; Abdel-Wahab, Mohamed ^{[6, 7]} ; Soliman, Osama ^{[8, 3]} ; Onuma, Yoshinobu ^{[8, 3]} ; Van Mieghem, Nicolas M. ^[3] ; Serruys, Patrick W. ^[9]

Affiliation

^[1] Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Amsterdam - Netherlands

^[2] Univ Campinas UNICAMP, Dept Internal Med, Div Cardiol, Campinas, SP - Brazil

^[3] Erasmus MC, Dept Cardiol, Rotterdam - Netherlands

^[4] Yamaguchi Univ, Div Cardiol, Dept Clin Sci & Med, Grad Sch Med, Ube, Yamaguchi - Japan

^[5] McGill Univ, Ctr Hlth, Div Cardiol, Montreal, PQ H3A 2T5 - Canada

^[6] Segeberger Kliniken, Ctr Heart, Bad Segeberg - Germany

^[7] Univ Leipzig, Dept Cardiol, Heart Ctr Leipzig, Leipzig - Germany

^[8] Cardialysis Clin Trials Management & Core Labs, Rotterdam - Netherlands

^[9] Imperial Coll London, Dept Cardiol, London - England

• Document type: Journal article
• Source: EUROINTERVENTION; v. 15, n. 5, p. 420+, AUG 2019.
• Web of Science Citations: 1

Abstract

Aims: Quantitative aortography using videodensitometry is a valuable tool for quantifying paravalvular regurgitation after TAVI, especially in the minimalist approach - without general anaesthesia. However, retrospective assessment of aortograms showed moderate feasibility of assessment. We sought to determine the prospective feasibility of quantitative aortography after a protocol of acquisition. Methods and results: This was a multicentre registry in Japan, Canada, the Netherlands and Germany including consecutive patients with Heart Team indication to undergo TAVI over a median period of 12 months. Operators performed final aortograms according to a pre-planned projection (either by CT or visually - Teng's rule). An independent core laboratory (Cardialysis) analysed all images for feasibility and for regurgitation assessment. From the four centres included in the present analysis, a total of 354 patients underwent TAVI following the acquisition protocol and all the aortograms were analysed by the core lab. The analyses were feasible in 95.5% (95% confidence interval {[}CI]: 93.2% to 97.5%) of the cases. This rate of analysable assessment was significantly higher than the feasibility in previous validation studies, such as in the RESPOND population (95.5% vs. 57.5%, p<0.0001). No differences were observed among different planning strategies (CT 96.5% vs. Teng's rule 93%, p=0.159; or Circle 98.5% vs. 3mensio 95.8% vs. Teng's rule 93%, p=0.247). Conclusions: ASSESS-REGURGE showed a high feasibility of assessment of regurgitation with quantitative aortography with protocoled acquisition. This may be of great importance for quantifying regurgitation in TAVI procedures (optimisation, guidance of post-dilatation), and in future clinical trials, in order to address sealing features of novel devices for TAVI objectively. (AU)

• FAPESP's process: 17/22013-8 - IMPACT OF CORONARY ARTERY COMPLEXITY ON MORTALITY AND CARDIOVASCULAR EVENTS IN PATIENTS WITH STEMI UNDER DIFFERENT ANTIPLATELET REGIMEN
• Grantee: Rodrigo Gimenez Pissutti Modolo
• Support Opportunities: Scholarships abroad - Research