Frontiers in Cardiovascular Medicine (Jul 2023)
Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement
- Mahmoud Abdelshafy,
- Mahmoud Abdelshafy,
- Patrick W. Serruys,
- Patrick W. Serruys,
- Tsung-Ying Tsai,
- Pruthvi Chenniganahosahalli Revaiah,
- Scot Garg,
- Jean-Paul Aben,
- Carl J. Schultz,
- Carl J. Schultz,
- Mohammad Abdelghani,
- Mohammad Abdelghani,
- Pim A. L. Tonino,
- Yosuke Miyazaki,
- Marcel C. M. Rutten,
- Martijn Cox,
- Cherif Sahyoun,
- Justin Teng,
- Hiroki Tateishi,
- Hiroki Tateishi,
- Mohamed Abdel-Wahab,
- Nicolo Piazza,
- Michele Pighi,
- Rodrigo Modolo,
- Martijn van Mourik,
- Joanna Wykrzykowska,
- Robbert J. de Winter,
- Pedro A. Lemos,
- Fábio S. de Brito,
- Hideyuki Kawashima,
- Lars Søndergaard,
- Liesbeth Rosseel,
- Rutao Wang,
- Chao Gao,
- Ling Tao,
- Andreas Rück,
- Won-Keun Kim,
- Niels van Royen,
- Christian J. Terkelsen,
- Henrik Nissen,
- Matti Adam,
- Tanja K. Rudolph,
- Hendrik Wienemann,
- Ryo Torii,
- Franz Josef Neuman,
- Simon Schoechlin,
- Mao Chen,
- Ahmed Elkoumy,
- Ahmed Elkoumy,
- Hesham Elzomor,
- Hesham Elzomor,
- Ignacio J. Amat-Santos,
- Darren Mylotte,
- Osama Soliman,
- Yoshinobu Onuma
Affiliations
- Mahmoud Abdelshafy
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Mahmoud Abdelshafy
- Department of Cardiology, Al-Azhar University, Cairo, Egypt
- Patrick W. Serruys
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Patrick W. Serruys
- NHLI, Imperial College London, London, United Kingdom
- Tsung-Ying Tsai
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Pruthvi Chenniganahosahalli Revaiah
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Scot Garg
- Department of Cardiology, Royal Blackburn Hospital, Blackburn, United Kingdom
- Jean-Paul Aben
- Pie Medical Imaging, Maastricht, Netherlands
- Carl J. Schultz
- Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
- Carl J. Schultz
- Medical School, University of Western Australia, Perth, WA, Australia
- Mohammad Abdelghani
- Department of Cardiology, Al-Azhar University, Cairo, Egypt
- Mohammad Abdelghani
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, Netherlands
- Pim A. L. Tonino
- Department of Cardiology, Catharina Hospital, Eindhoven, Netherlands
- Yosuke Miyazaki
- 0Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
- Marcel C. M. Rutten
- 1Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Martijn Cox
- 2Xeltis B.V., Eindhoven, Netherlands
- Cherif Sahyoun
- 3Philips Healthcare, Best, Leipzig, Netherlands
- Justin Teng
- Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
- Hiroki Tateishi
- 4Department of Cardiology, Shibata Hospital, Yamaguchi, Japan
- Hiroki Tateishi
- 5Division of Cardiology, Department of Clinical Science and Medicine, Yamaguchi University Graduate School of Medicine, Ube, Japan
- Mohamed Abdel-Wahab
- 6Department of Internal Medicine/Cardiology, Heart Center Leipzig at the University of Leipzig, Leipzig, Germany
- Nicolo Piazza
- 7Department of Medicine, Division of Cardiology, McGill University, Montreal, QC, Canada
- Michele Pighi
- 8Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
- Rodrigo Modolo
- 9Boston Scientific, Maple Grove, MN, United States
- Martijn van Mourik
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, Netherlands
- Joanna Wykrzykowska
- 0Department of Cardiology, University Medical Centre, Groningen, Netherlands
- Robbert J. de Winter
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, Netherlands
- Pedro A. Lemos
- 1Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil
- Fábio S. de Brito
- 1Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil
- Hideyuki Kawashima
- 2Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
- Lars Søndergaard
- 3The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Liesbeth Rosseel
- 4Department of Cardiology, Algemeen Stedelijk Ziekenhuis, Aalst, Belgium
- Rutao Wang
- 5Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
- Chao Gao
- 5Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
- Ling Tao
- 5Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
- Andreas Rück
- 6Department of Cardiology, Karolinska Institute, Stockholm, Sweden
- Won-Keun Kim
- 7Department of Cardiology, Kerckhoff Heart Centre, Bad Nauheim, Germany
- Niels van Royen
- 8Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
- Christian J. Terkelsen
- 9Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Henrik Nissen
- 0Department of Cardiology, Odense University Hospital, Odense, Denmark
- Matti Adam
- 1Department of Cardiology, Faculty of Medicine, Heart Center, University of Cologne, Cologne, Germany
- Tanja K. Rudolph
- 2Department for General and Interventional Cardiology/Angiology, Heart- und Diabetes Center NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
- Hendrik Wienemann
- 1Department of Cardiology, Faculty of Medicine, Heart Center, University of Cologne, Cologne, Germany
- Ryo Torii
- 3Department of Mechanical Engineering, University College London, London, United Kingdom
- Franz Josef Neuman
- 4Division of Cardiology and Angiology II, University Heart Centre Freiburg—Bad Krozingen, Bad Krozingen, Germany
- Simon Schoechlin
- 5Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
- Mao Chen
- 5Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
- Ahmed Elkoumy
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Ahmed Elkoumy
- 6Islamic Center of Cardiology and Cardiac Surgery, Al-Azhar University, Cairo, Egypt
- Hesham Elzomor
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Hesham Elzomor
- 6Islamic Center of Cardiology and Cardiac Surgery, Al-Azhar University, Cairo, Egypt
- Ignacio J. Amat-Santos
- 7CIBERCV, Cardiology Department, Hospital Clínico de Valladolid, Valladolid, Spain
- Darren Mylotte
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Osama Soliman
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Yoshinobu Onuma
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- DOI
- https://doi.org/10.3389/fcvm.2023.1161779
- Journal volume & issue
-
Vol. 10
Abstract
Paravalvular leak (PVL) is a shortcoming that can erode the clinical benefits of transcatheter valve replacement (TAVR) and therefore a readily applicable method (aortography) to quantitate PVL objectively and accurately in the interventional suite is appealing to all operators. The ratio between the areas of the time-density curves in the aorta and left ventricular outflow tract (LVOT-AR) defines the regurgitation fraction (RF). This technique has been validated in a mock circulation; a single injection in diastole was further tested in porcine and ovine models. In the clinical setting, LVOT-AR was compared with trans-thoracic and trans-oesophageal echocardiography and cardiac magnetic resonance imaging. LVOT-AR > 17% discriminates mild from moderate aortic regurgitation on echocardiography and confers a poor prognosis in multiple registries, and justifies balloon post-dilatation. The LVOT-AR differentiates the individual performances of many old and novel devices and is being used in ongoing randomized trials and registries.
Keywords
- aortic regurgitation
- paravalvular leak
- videodensitometry
- transcatheter aortic valve replacement
- transcatheter aortic valve implantation
- quantitative aortography
