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Abdelshafy M, Serruys PW, Tsai TY, Revaiah PC, Garg S, Aben JP, Schultz CJ, Abdelghani M, Tonino PAL, Miyazaki Y, Rutten MCM, Cox M, Sahyoun C, Teng J, Tateishi H, Abdel-Wahab M, Piazza N, Pighi M, Modolo R, van Mourik M, Wykrzykowska J, de Winter RJ, Lemos PA, de Brito FS, Kawashima H, Søndergaard L, Rosseel L, Wang R, Gao C, Tao L, Rück A, Kim WK, van Royen N, Terkelsen CJ, Nissen H, Adam M, Rudolph TK, Wienemann H, Torii R, Josef Neuman F, Schoechlin S, Chen M, Elkoumy A, Elzomor H, Amat-Santos IJ, Mylotte D, Soliman O, Onuma Y. Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement. Front Cardiovasc Med 2023; 10:1161779. [PMID: 37529710 PMCID: PMC10389707 DOI: 10.3389/fcvm.2023.1161779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/24/2023] [Indexed: 08/03/2023] Open
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.
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Affiliation(s)
- Mahmoud Abdelshafy
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- 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
- 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
| | | | - Carl J. Schultz
- Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
- Medical School, University of Western Australia, Perth, WA, Australia
| | - Mohammad Abdelghani
- Department of Cardiology, Al-Azhar University, Cairo, Egypt
- 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
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Marcel C. M. Rutten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | | | | | - Justin Teng
- Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
| | - Hiroki Tateishi
- Department of Cardiology, Shibata Hospital, Yamaguchi, Japan
- Division of Cardiology, Department of Clinical Science and Medicine, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Mohamed Abdel-Wahab
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at the University of Leipzig, Leipzig, Germany
| | - Nicolo Piazza
- Department of Medicine, Division of Cardiology, McGill University, Montreal, QC, Canada
| | - Michele Pighi
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | | | - Martijn van Mourik
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, Netherlands
| | | | - Robbert J. de Winter
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Pedro A. Lemos
- Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil
| | - Fábio S. de Brito
- Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil
| | - Hideyuki Kawashima
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Lars Søndergaard
- The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Liesbeth Rosseel
- Department of Cardiology, Algemeen Stedelijk Ziekenhuis, Aalst, Belgium
| | - Rutao Wang
- Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Chao Gao
- Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Ling Tao
- Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Andreas Rück
- Department of Cardiology, Karolinska Institute, Stockholm, Sweden
| | - Won-Keun Kim
- Department of Cardiology, Kerckhoff Heart Centre, Bad Nauheim, Germany
| | - Niels van Royen
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Henrik Nissen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Matti Adam
- Department of Cardiology, Faculty of Medicine, Heart Center, University of Cologne, Cologne, Germany
| | - Tanja K. Rudolph
- Department for General and Interventional Cardiology/Angiology, Heart- und Diabetes Center NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Hendrik Wienemann
- Department of Cardiology, Faculty of Medicine, Heart Center, University of Cologne, Cologne, Germany
| | - Ryo Torii
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Franz Josef Neuman
- Division of Cardiology and Angiology II, University Heart Centre Freiburg—Bad Krozingen, Bad Krozingen, Germany
| | - Simon Schoechlin
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Mao Chen
- Department 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
- Islamic 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
- Islamic Center of Cardiology and Cardiac Surgery, Al-Azhar University, Cairo, Egypt
| | | | - 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
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The 20-year “imaging saga” for transcatheter aortic valve implantation: A viewpoint. Arch Cardiovasc Dis 2022; 115:225-230. [DOI: 10.1016/j.acvd.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/20/2022]
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Wang R, Kawashima H, Gao C, Mou F, Li P, Zhang J, Yang J, Luo J, Mylotte D, Wijns W, Onuma Y, Soliman O, Tao L, Serruys PW. Comparative Quantitative Aortographic Assessment of Regurgitation in Patients Treated With VitaFlow Transcatheter Heart Valve vs. Other Self-Expanding Systems. Front Cardiovasc Med 2022; 8:747174. [PMID: 35146004 PMCID: PMC8821967 DOI: 10.3389/fcvm.2021.747174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022] Open
Abstract
Objectives To compare the quantitative angiographic aortic regurgitation (AR) of six self-expanding valves after transcatheter aortic valve replacement (TAVR). Background Quantitative videodensitometric aortography (LVOT-AR) is an accurate and reproducible tool for assessment of AR following TAVR. Methods This is a retrospective central core-lab analysis of 1,257 consecutive cine aortograms performed post-TAVR. The study included 107 final aortograms of consecutive patients who underwent TAVR with first-generation VitaFlow in four Chinese centers and 1,150 aortograms with five other transcatheter aortic valves (Evolut Pro, Evolut R, CoreValve, Venus A-Valve, and Acurate Neo). LVOT-AR analyses of these five valves were retrieved from a previously published pooled database. Results Among 172 aortograms of patients treated with VitaFlow, 107 final aortograms (62.2%) were analyzable by LVOT-AR. In this first in man eight cases necessitated a procedural valve in valve due to inappropriate TAVR positioning and severe aortic paravalvular regurgitation. In the VitaFlow group, the mean LVOT-AR of the intermediate aortograms was 7.3 ± 7.8% and the incidence of LVOT-AR >17% was 8.6%. The mean LVOT-AR of the final aortogram was 6.1 ± 6.4% in the VitaFlow group, followed by Evolut Pro (7.3 ± 6.5%), Evolut R (7.9 ± 7.4%), Venus A-valve (8.9 ± 10.0%), Acurate Neo (9.6 ± 9.2%), and lastly CoreValve (13.7 ± 10.7%) (analysis of variance p < 0.001). Post hoc 2-by-2 testing showed that CoreValve had significantly higher LVOT-AR compared with each of the other five THVs. No statistical difference in LVOT-AR was observed between VitaFlow, Evolut Pro, Evolut R, Acurate Neo, and Venus A-valves. The VitaFlow system had the lowest proportion of patients with LVOT-AR >17% (4.7%) (AR after the final aortograms), followed by Evolut Pro (5.3%), Evolut R (8.8%), Acurate Neo (11.3%), Venus A-valve (14.2%), and CoreValve (30.1%) (chi-square p < 0.001). Conclusion Compared to other commercially available self-expanding valves, VitaFlow seems to have a low degree of AR and a low proportion of patients with ≥moderate/severe AR as assessed by quantitative videodensitometric angiography. Once the learning phase is completed, comparisons of AR between different transcatheter heart valves should be attempted in a prospective randomized trial.
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Affiliation(s)
- Rutao Wang
- Department of Cardiology, Xijing Hospital, Xi'an, China
- Department of Cardiology, CORRIB Research Center for Advanced Imaging and Core Laboratory, National University of Ireland, NUIG, Galway, Ireland
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Hideyuki Kawashima
- Department of Cardiology, CORRIB Research Center for Advanced Imaging and Core Laboratory, National University of Ireland, NUIG, Galway, Ireland
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Chao Gao
- Department of Cardiology, Xijing Hospital, Xi'an, China
- Department of Cardiology, CORRIB Research Center for Advanced Imaging and Core Laboratory, National University of Ireland, NUIG, Galway, Ireland
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Fangjun Mou
- Department of Cardiology, Xijing Hospital, Xi'an, China
| | - Ping Li
- Department of Cardiology, Yulin First People's Hospital, The Sixth Affiliated Hospital of Guangxi Medical University, Yulin, China
| | - Junjie Zhang
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jian Yang
- Department of Cardiovascular Surgery, Xijing Hospital, Xi'an, China
| | - Jianfang Luo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Darren Mylotte
- Department of Cardiology, CORRIB Research Center for Advanced Imaging and Core Laboratory, National University of Ireland, NUIG, Galway, Ireland
| | - William Wijns
- Department of Cardiology, CORRIB Research Center for Advanced Imaging and Core Laboratory, National University of Ireland, NUIG, Galway, Ireland
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland Galway (NUIG), Galway, Ireland
| | - Yoshinobu Onuma
- Department of Cardiology, CORRIB Research Center for Advanced Imaging and Core Laboratory, National University of Ireland, NUIG, Galway, Ireland
| | - Osama Soliman
- Department of Cardiology, CORRIB Research Center for Advanced Imaging and Core Laboratory, National University of Ireland, NUIG, Galway, Ireland
| | - Ling Tao
- Department of Cardiology, Xijing Hospital, Xi'an, China
- *Correspondence: Ling Tao
| | - Patrick W. Serruys
- Department of Cardiology, CORRIB Research Center for Advanced Imaging and Core Laboratory, National University of Ireland, NUIG, Galway, Ireland
- Department of Cardiology, Imperial College London, London, United Kingdom
- Patrick W. Serruys
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Rück A, Kim WK, Kawashima H, Abdelshafy M, Elkoumy A, Elzomor H, Wang R, Meduri CU, Verouhis D, Saleh N, Onuma Y, Mylotte D, Serruys PW, Soliman O. Paravalvular Aortic Regurgitation Severity Assessed by Quantitative Aortography: ACURATE neo2 versus ACURATE neo Transcatheter Aortic Valve Implantation. J Clin Med 2021; 10:jcm10204627. [PMID: 34682750 PMCID: PMC8539505 DOI: 10.3390/jcm10204627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 12/29/2022] Open
Abstract
The new-generation ACURATE neo2 system was commercially released in September 2020. In this study, we sought to compare the aortic regurgitation (AR) severity of the ACURATE neo2 versus the ACURATE neo transcatheter heart valve, using quantitative videodensitometric angiography (qAR). This is a retrospective, Corelab analysis of final post-transcatheter aortic valve implantation (TAVI) aortograms of patients treated with the ACURATE neo2 and ACURATE neo systems. The ACURATE neo2 cohort comprised consecutive patients treated between September 2020 and January 2021 at two centers. The ACURATE neo cohort included consecutive patients treated before September 2020. Our primary objective was to compare AR severity on qAR following TAVI with ACURATE neo2 and ACURATE neo. Out of 401 aortograms, 228 (56.9%) were analyzable, with 120 in the ACURATE neo2 cohort, and 108 in the ACURATE neo cohort. The mean AR fraction was 4.4 ± 4.8% in the neo2 cohort, and 9.9 ± 8.2% in the neo cohort (p < 0.001). Furthermore, moderate or severe AR (qAR > 17%) was detected in 2 aortograms (1.7%) in the neo2 cohort and 15 aortograms (13.9%) in the neo cohort (p < 0.001). Quantitative aortography shows a lower rate of moderate or severe paravalvular AR in what is the first European experience of the new-generation, self-expanding ACURATE neo2 when compared to the first-generation ACURATE neo. Moreover, aortographic data need to be correlated and compared to Core Laboratory-adjudicated 30-day echocardiographic data.
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Affiliation(s)
- Andreas Rück
- Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; (A.R.); (C.U.M.); (D.V.); (N.S.)
| | - Won-Keun Kim
- Kerckhoff Heart Center, Department of Cardiology, 61231 Bad Nauheim, Germany;
| | - Hideyuki Kawashima
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, National University of Ireland Galway (NUIG), H91 V4AY Galway, Ireland; (H.K.); (M.A.); (A.E.); (H.E.); (R.W.); (Y.O.); (D.M.); (P.W.S.)
- Academic Medical Centre, Department of Cardiology, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Mahmoud Abdelshafy
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, National University of Ireland Galway (NUIG), H91 V4AY Galway, Ireland; (H.K.); (M.A.); (A.E.); (H.E.); (R.W.); (Y.O.); (D.M.); (P.W.S.)
| | - Ahmed Elkoumy
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, National University of Ireland Galway (NUIG), H91 V4AY Galway, Ireland; (H.K.); (M.A.); (A.E.); (H.E.); (R.W.); (Y.O.); (D.M.); (P.W.S.)
| | - Hesham Elzomor
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, National University of Ireland Galway (NUIG), H91 V4AY Galway, Ireland; (H.K.); (M.A.); (A.E.); (H.E.); (R.W.); (Y.O.); (D.M.); (P.W.S.)
| | - Rutao Wang
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, National University of Ireland Galway (NUIG), H91 V4AY Galway, Ireland; (H.K.); (M.A.); (A.E.); (H.E.); (R.W.); (Y.O.); (D.M.); (P.W.S.)
- Department of Cardiology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Christopher U. Meduri
- Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; (A.R.); (C.U.M.); (D.V.); (N.S.)
| | - Dinos Verouhis
- Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; (A.R.); (C.U.M.); (D.V.); (N.S.)
| | - Nawzad Saleh
- Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; (A.R.); (C.U.M.); (D.V.); (N.S.)
| | - Yoshinobu Onuma
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, National University of Ireland Galway (NUIG), H91 V4AY Galway, Ireland; (H.K.); (M.A.); (A.E.); (H.E.); (R.W.); (Y.O.); (D.M.); (P.W.S.)
| | - Darren Mylotte
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, National University of Ireland Galway (NUIG), H91 V4AY Galway, Ireland; (H.K.); (M.A.); (A.E.); (H.E.); (R.W.); (Y.O.); (D.M.); (P.W.S.)
| | - Patrick W. Serruys
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, National University of Ireland Galway (NUIG), H91 V4AY Galway, Ireland; (H.K.); (M.A.); (A.E.); (H.E.); (R.W.); (Y.O.); (D.M.); (P.W.S.)
- CÚRAM, the SFI Research Centre for Medical Devices, H91 TK33 Galway, Ireland
- NHLI, Imperial College London, London SW7 2AZ, UK
| | - Osama Soliman
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, National University of Ireland Galway (NUIG), H91 V4AY Galway, Ireland; (H.K.); (M.A.); (A.E.); (H.E.); (R.W.); (Y.O.); (D.M.); (P.W.S.)
- CÚRAM, the SFI Research Centre for Medical Devices, H91 TK33 Galway, Ireland
- Correspondence: ; Tel.: +353-91-493-781
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Kawashima H, Serruys PW, Modolo R, Pighi M, Wang R, Ono M, Aben JP, Chang CC, Van Hauwermeiren H, Brunnett B, Cox M, Rosseel L, Mylotte D, Pibarot P, Flameng WJ, Onuma Y, Soliman O. Validation of Prosthetic Mitral Regurgitation Quantification Using Novel Angiographic Platform by Mock Circulation. JACC Cardiovasc Interv 2021; 14:1523-1534. [PMID: 34217623 DOI: 10.1016/j.jcin.2021.04.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/22/2021] [Accepted: 04/27/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aimed to validate a dedicated software for quantitative videodensitometric angiographic assessment of mitral regurgitation (QMR). BACKGROUND Quantitative videodensitometric aortography of aortic regurgitation using the time-density principle is a well-documented technique, but the angiographic assessment of mitral regurgitation (MR) remains at best semi-quantitative and operator dependent. METHODS Fourteen sheep underwent surgical mitral valve replacement using 2 different prostheses. Pre-sacrifice left ventriculograms were used to assess MR fraction (MRF) using QMR and MR volume (MRV). In an independent core lab, the CAAS QMR 0.1 was used for QMR analysis. In vitro MRF and MRV were assessed in a mock circulation at a comparable cardiac output to the in vivo one by thermodilution. The correlations and agreements of in vitro and in vivo MRF, MRV, and interobserver reproducibility for QMR analysis were assessed using the averaged cardiac cycles (CCs). RESULTS In vivo derived MRF by QMR strongly correlated with in vitro derived MRF, regardless of the number of the CCs analyzed (best correlation: 3 CCs y = 0.446 + 0.994x; R = 0.784; p =0.002). The mean absolute difference between in vitro derived MRF and in vivo derived MRF from 3 CCs was 0.01 ± 4.2% on Bland-Altman analysis. In vitro MRV and in vivo MRV from 3 CCs were very strongly correlated (y = 0.196 + 1.255x; R = 0.839; p < 0.001). The mean absolute difference between in vitro MRV and in vivo MRV from 3 CCs was -1.4 ± 1.9 ml. There were very strong correlations of in vivo MRF between 2 independent analysts, regardless of the number of the CCs. CONCLUSIONS In vivo MRF using the novel software is feasible, accurate, and highly reproducible. These promising results have led us to initiate the first human feasibility study comprising patients undergoing percutaneous mitral valve edge-to-edge repair.
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Affiliation(s)
- Hideyuki Kawashima
- Department of Cardiology, National University of Ireland, Galway (NUIG) and CORRIB Corelab and Center for Research and Imaging, Galway, Ireland; Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland, Galway (NUIG) and CORRIB Corelab and Center for Research and Imaging, Galway, Ireland; Department of Cardiology, Imperial College of London, London, United Kingdom.
| | - Rodrigo Modolo
- Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; Cardiology Division, Department of Internal Medicine, University of Campinas, Campinas, Brazil
| | - Michele Pighi
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Rutao Wang
- Department of Cardiology, National University of Ireland, Galway (NUIG) and CORRIB Corelab and Center for Research and Imaging, Galway, Ireland; Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Masafumi Ono
- Department of Cardiology, National University of Ireland, Galway (NUIG) and CORRIB Corelab and Center for Research and Imaging, Galway, Ireland; Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Chun Chin Chang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | | | | | - Liesbeth Rosseel
- Department of Cardiology, National University of Ireland, Galway (NUIG) and CORRIB Corelab and Center for Research and Imaging, Galway, Ireland
| | - Darren Mylotte
- Department of Cardiology, National University of Ireland, Galway (NUIG) and CORRIB Corelab and Center for Research and Imaging, Galway, Ireland
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Université Laval, Québec City, Québec, Canada
| | - Willem J Flameng
- Department of Cardiac Surgery, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway (NUIG) and CORRIB Corelab and Center for Research and Imaging, Galway, Ireland
| | - Osama Soliman
- Department of Cardiology, National University of Ireland, Galway (NUIG) and CORRIB Corelab and Center for Research and Imaging, Galway, Ireland
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Modolo R, van Mourik M, El Bouziani A, Kawashima H, Rosseel L, Abdelghani M, Aben JP, Slots T, Sahyoun C, Baan J, Henriques JPS, Koch KT, Vis M, Soliman O, Onuma Y, Wykrzykowska J, de Winter R, Serruys PW. Online Quantitative Aortographic Assessment of Aortic Regurgitation After TAVR: Results of the OVAL Study. JACC Cardiovasc Interv 2021; 14:531-538. [PMID: 33582086 DOI: 10.1016/j.jcin.2020.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the online assessment feasibility of aortography using videodensitometry in the catheterization laboratory during transcatheter aortic valve replacement (TAVR). BACKGROUND Quantitative assessment of regurgitation after TAVR through aortography using videodensitometry is simple, reproducible, and validated in vitro, in vivo, in clinical trials, and in "real-world" patients. However, thus far the assessment has been done offline. METHODS This was a single center, prospective, proof-of-principle, feasibility study. One hundred consecutive patients with aortic stenosis and indications to undergo TAVR were enrolled. All final aortograms were analyzed immediately after acquisition in the catheterization laboratory and were also sent to an independent core laboratory for blinded offline assessment. The primary endpoint of the study was the feasibility of the online assessment of regurgitation (percentage of analyzable cases). The secondary endpoint was the reproducibility of results between the online assessment and the offline analysis by the core laboratory. RESULTS Patients' mean age was 81 ± 7 years, and 56% were men. The implanted valves were either SAPIEN 3 (97%) or SAPIEN 3 Ultra (3%). The primary endpoint of online feasibility of analysis was 92% (95% confidence interval [CI]: 86% to 97%) which was the same feasibility encountered by the core laboratory (92%; 95% CI: 86% to 97%). Reproducibility assessment showed a high correlation between online and core laboratory evaluations (R2 = 0.87, p < 0.001), with an intraclass correlation coefficient of 0.962 (95% CI: 0.942 to 0.975; p < 0.001). CONCLUSIONS This study showed high feasibility of online quantitative assessment of regurgitation and high agreement between the online examiner and core laboratory. These results may pave the way for the application of videodensitometry in the catheterization laboratory after TAVR. (Online Videodensitometric Assessment of Aortic Regurgitation in the Cath-Lab [OVAL]; NCT04047082).
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Affiliation(s)
- Rodrigo Modolo
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands; Department of Internal Medicine, Cardiology Division, University of Campinas, Campinas, Brazil; Department of Cardiology, Hospital Vera Cruz de Campinas, Campinas, Brazil
| | - Martijn van Mourik
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Abdelhak El Bouziani
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Hideyuki Kawashima
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands; Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Liesbeth Rosseel
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Mohammad Abdelghani
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands; Department of Cardiology, Al-Azhar University, Cairo, Egypt
| | | | | | | | - Jan Baan
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Jose P S Henriques
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Karel T Koch
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Marije Vis
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Osama Soliman
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Joanna Wykrzykowska
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Robbert de Winter
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland; Department of Cardiology, Imperial College of London, London, United Kingdom.
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Modolo R, Chang CC, Onuma Y, Schultz C, Tateishi H, Abdelghani M, Miyazaki Y, Aben JP, Rutten MC, Pighi M, El Bouziani A, van Mourik M, Lemos PA, Wykrzykowska JJ, Brito FS, Sahyoun C, Piazza N, Eltchaninoff H, Soliman O, Abdel-Wahab M, Van Mieghem NM, de Winter RJ, Serruys PW. Quantitative aortography assessment of aortic regurgitation. EUROINTERVENTION 2020; 16:e738-e756. [DOI: 10.4244/eij-d-19-00879] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Modolo R, Chang CC, Abdelghani M, Kawashima H, Ono M, Tateishi H, Miyazaki Y, Pighi M, Wykrzykowska JJ, de Winter RJ, Ruck A, Chieffo A, van Mourik MS, Yamaji K, Richardt G, de Brito FS, Lemos PA, Al-Kassou B, Piazza N, Tchetche D, Sinning JM, Abdel-Wahab M, Soliman O, Søndergaard L, Mylotte D, Onuma Y, Van Mieghem NM, Serruys PW. Quantitative Assessment of Acute Regurgitation Following TAVR. JACC Cardiovasc Interv 2020; 13:1303-1311. [DOI: 10.1016/j.jcin.2020.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 12/30/2022]
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