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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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Elzomor H, Chen M, Chen F, Onuma Y, Soliman O, Piazza N, Serruys PW. Quantitative videodensitometric assessment of residual mitral regurgitation after transcatheter mitral valve replacement: a first-in-human report from China. ASIAINTERVENTION 2022; 8:158-159. [PMID: 36483272 PMCID: PMC9706724 DOI: 10.4244/aij-d-22-00058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/16/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Hesham Elzomor
- Department of Cardiology, National University of Ireland Galway (NUIG) and CORRIB Corelab and Center for Research and Imaging, Galway, Ireland
- Islamic Center of Cardiology and Cardiac Surgery, Al-Azhar University, Cairo, Egypt
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Fei Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - 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
| | - Nicolo Piazza
- McGill University Health Centre, Montreal, Québec, Canada
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland Galway (NUIG) and CORRIB Corelab and Center for Research and Imaging, Galway, Ireland
- Imperial College of London, London, UK
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