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  • Elkoumy, AhmedGalway University Hospital (författare)

Core Lab Adjudication of the ACURATE neo2 Hemodynamic Performance Using Computed-Tomography-Corrected Left Ventricular Outflow Tract Area

  • Artikel/kapitelEngelska2022

Förlag, utgivningsår, omfång ...

  • 2022-10-17
  • MDPI AG,2022

Nummerbeteckningar

  • LIBRIS-ID:oai:lup.lub.lu.se:287b58fb-4e9f-4d28-923f-35a1b83fbb43
  • https://lup.lub.lu.se/record/287b58fb-4e9f-4d28-923f-35a1b83fbb43URI
  • https://doi.org/10.3390/jcm11206103DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:151067964URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:art swepub-publicationtype
  • Ämneskategori:ref swepub-contenttype

Anmärkningar

  • (1) Background: Hemodynamic assessment of prosthetic heart valves using conventional 2D transthoracic Echocardiography-Doppler (2D-TTE) has limitations. Of those, left ventricular outflow tract (LVOT) area measurement is one of the major limitations of the continuity equation, which assumes a circular LVOT. (2) Methods: This study comprised 258 patients with severe aortic stenosis (AS), who were treated with the ACURATE neo2. The LVOT area and its dependent Doppler-derived parameters, including effective orifice area (EOA) and stroke volume (SV), in addition to their indexed values, were calculated from post-TAVI 2D-TTE. In addition, the 3D-LVOT area from pre-procedural MDCT scans was obtained and used to calculate corrected Doppler-derived parameters. The incidence rates of prosthesis patient mismatch (PPM) were compared between the 2D-TTE and MDCT-based methods (3) Results: The main results show that the 2D-TTE measured LVOT is significantly smaller than 3D-MDCT (350.4 ± 62.04 mm2 vs. 405.22 ± 81.32 mm2) (95% Credible interval (CrI) of differences: −55.15, −36.09), which resulted in smaller EOA (2.25 ± 0.59 vs. 2.58 ± 0.63 cm2) (Beta = −0.642 (95%CrI of differences: −0.85, −0.43), and lower SV (73.88 ± 21.41 vs. 84.47 ± 22.66 mL), (Beta = −7.29 (95% CrI: −14.45, −0.14)), respectively. PPM incidence appears more frequent with 2D-TTE- than 3D-MDCT-corrected measurements (based on the EOAi) 8.52% vs. 2.32%, respectively. In addition, significant differences regarding the EOA among the three valve sizes (S, M and L) were seen only with the MDCT, but not on 2D-TTE. (4) Conclusions: The corrected continuity equation by combining the 3D-LVOT area from MDCT with the TTE Doppler parameters might provide a more accurate assessment of hemodynamic parameters and PPM diagnosis in patients treated with TAVI. The ACURATE neo2 THV has a large EOA and low incidence of PPM using the 3D-corrected LVOT area than on 2D-TTE. These findings need further confirmation on long-term follow-up and in other studies.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Rück, AndreasKarolinska Institutet,Karolinska University Hospital (författare)
  • Kim, Won KeunMax Planck Institute for Heart and Lung Research (författare)
  • Abdel-Wahab, MohamedLeipzig University (författare)
  • Abdelshafy, MahmoudGalway University Hospital (författare)
  • De Backer, OleCopenhagen University Hospital (författare)
  • Elzomor, HeshamGalway University Hospital (författare)
  • Hengstenberg, ChristianMedical University of Vienna (författare)
  • Mohamed, Sameh K.Galway University Hospital (författare)
  • Saleh, NawzadKarolinska Institutet,Karolinska University Hospital (författare)
  • Arsang-Jang, ShahramGalway University Hospital (författare)
  • Bjursten, HenrikLund University,Lunds universitet,Skonsammare hjärtkirurgi,Forskargrupper vid Lunds universitet,Less invasive cardiac surgery,Lund University Research Groups,Skåne University Hospital(Swepub:lu)thor-hjo (författare)
  • Simpkin, AndrewNational University of Ireland Galway (författare)
  • Meduri, Christopher U.Karolinska University Hospital (författare)
  • Soliman, OsamaGalway University Hospital (författare)
  • Karolinska InstitutetGalway University Hospital (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Journal of Clinical Medicine: MDPI AG11:20, s. 1-122077-0383

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