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Chourdakis E, Koniari I, Kounis NG, Velissaris D, Koutsogiannis N, Tsigkas G, Hauptmann KE, Sontag B, Hahalis G. The role of echocardiography and CT angiography in transcatheter aortic valve implantation patients. J Geriatr Cardiol 2018; 15:86-94. [PMID: 29434630 PMCID: PMC5803542 DOI: 10.11909/j.issn.1671-5411.2018.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 01/06/2018] [Accepted: 01/13/2018] [Indexed: 12/13/2022] Open
Abstract
The transcatheter aortic valve implantation (TAVI) consist an alternative treatment in patients with severe aortic stenosis. Multimodality imaging using transthoracic echocardiography (TTE) or transesophageal echocardiography (TOE) and multislice CT (MSCT) constitute cornerstone techniques for the pre-operative management, peri-procedural guidance, follow up and recognition of possible transcatheter valve related complications. CT angiography is much more accurate regarding the total definition of aortic annulus diameter and circumferential area. Two-dimensional (2D) echocardiography, underestimates the aortic valve annulus diameter compared to 3D imaging techniques (MSCT, MRI and 3D TOE). Three-dimensional TOE imaging provides measurements of the aortic valve annulus similar to those delivered by MSCT. The pre-procedural MSCT constitutes the gold standard modality minimizing the presence of paravalvular aortic regurgitation, one of the most frequent complications. TOE/TTE and MSCT performance could predict the possibility of pacemaker implantation post-procedural. The presence of a new transient or persisting MR can be assessed well by TOE. Both TTE and TOE, consist initially the basic examination for post TAVI evaluation. In case of transcatheter heart valve failure, the MSCT could be used as additional imaging technique.
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Affiliation(s)
| | - Ioanna Koniari
- Department of Cardiology, University Hospital of Patras, Rion, Patras, Greece
| | - Nicholas G Kounis
- Department of Cardiology, University Hospital of Patras, Rion, Patras, Greece
| | - Dimitrios Velissaris
- Department of Internal Medicine, University Hospital of Patras, Rion, Patras, Greece
| | | | - Grigorios Tsigkas
- Department of Cardiology, University Hospital of Patras, Rion, Patras, Greece
| | | | - Bruno Sontag
- Krankenhaus der Barmherzigen Brüder Trier, Germany
| | - George Hahalis
- Department of Cardiology, University Hospital of Patras, Rion, Patras, Greece
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Rougé A, Huttin O, Aslam R, Vaugrenard T, Jouve T, Angioi M, Maureira P. Mid-term results of 150 TAVI comparing apical versus femoral approaches. J Cardiothorac Surg 2015; 10:147. [PMID: 26530142 PMCID: PMC4632837 DOI: 10.1186/s13019-015-0360-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 10/28/2015] [Indexed: 11/10/2022] Open
Abstract
Background Transcatheter aortic-valve implantation (TAVI) is a new therapeutic choice for treating aortic stenosis in patients considered high risk for surgery. This blooming therapeutic technique still requires evaluation of medium and long term outcome. Method We hereby report our results of the first 150 consecutive patients to receive TAVI implants in our population recruited from July 2009 to March 2013 in a retrospective and monocentric study. We analyzed long term morbidity and mortality criteria. We compared the apical and femoral approach results and researched predictors of cardiac mortality. Results The mean monitoring period was 387.62 days, mean Euroscore was 21.8, and mean Society of Thoracic Surgeons (STS) risk score was 9.2. The success rate for the procedure was 94.6 %. A total of 39 patients died. The mortality rates at the immediate perioperative point, 30 days, 1 year, and 2 years, were 4 %, 11.3 %, 22.7 %, and 26 %, respectively. As regards complications, there were 10 hemodynamic complications (6.6 %) and 20 vascular (13.3 %), 11 cardiac tamponades (7.4 %), eight mechanical (5.3 %), ten major hemorrhagic (6.7 %), 14 pulmonary (9.3 %), and 18 infectious complications (12 %). When comparing the rates of reported complications in terms of different approaches, we observed significantly more hemodynamic complications in the apical group (p = 0.049). Pulmonary complications were also significantly more common in cases of apical approach (p = 0.029). The majority of the patients reported clear functional improvement throughout their follow-up. Conclusion The results of the first 150 patients to receive the implant at the Nancy University Teaching Hospital (CHU Nancy) were consistent with findings in the literature. TAVI proved a credible and effective alternative to surgical valve replacement for patients at high risk during surgery.
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Affiliation(s)
- Alain Rougé
- Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. .,Université de Lorraine, Nancy, France.
| | - Olivier Huttin
- Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. .,Université de Lorraine, Nancy, France.
| | - Rumas Aslam
- Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. .,Université de Lorraine, Nancy, France.
| | - Thibaud Vaugrenard
- Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. .,Université de Lorraine, Nancy, France.
| | - Thomas Jouve
- Service de Néphrologie - CHU Grenoble, Boulevard de la Chantourne, Grenoble, France.
| | - Michael Angioi
- Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. .,Université de Lorraine, Nancy, France.
| | - Pablo Maureira
- Service de Chirurgie Cardiaque, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. .,Université de Lorraine, Nancy, France.
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Salgado RA, Budde RPJ, Leiner T, Shivalkar B, Van Herck PL, Op de Beeck BJ, Vrints C, Buijsrogge MP, Stella PR, Rodrigus I, Bosmans J, Parizel PM. Transcatheter Aortic Valve Replacement: Postoperative CT Findings of Sapien and CoreValve Transcatheter Heart Valves. Radiographics 2014; 34:1517-36. [DOI: 10.1148/rg.346130149] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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