Large-field intravascular ultrasound for annular sizing and predicting paravalvular regurgitation during TAVR: comparisons with multidetector computed tomography and transoesophageal echocardiography
Abstract Aims The use of contrast media with multidetector computed tomography (MDCT) may induce acute kidney injury in patients with renal failure undergoing transcatheter aortic valve replacement (TAVR). We investigated the role of large-field intravascular ultrasound (IVUS) vs. MDCT and two-dimen...
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| Veröffentlicht in: | European heart journal cardiovascular imaging 2017-12, Vol.18 (12), p.1404-1413 |
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| creator | Hakim, Diaa Ghimire, Gopal Alli, Oluseun O Singh, Satinder Sasse, Mark F Booker, Oscar J Arora, Garima Leesar, Tara Jernigan, Lindsey Melby, Spencer J Davies, James E Leesar, Massoud A |
| description | Abstract
Aims
The use of contrast media with multidetector computed tomography (MDCT) may induce acute kidney injury in patients with renal failure undergoing transcatheter aortic valve replacement (TAVR). We investigated the role of large-field intravascular ultrasound (IVUS) vs. MDCT and two-dimensional transoesophageal echocardiography (2D-TEE) for annular sizing and predicting paravalvular regurgitation (PVR) during TAVR.
Methods and Results
The aortic annulus was measured by large-field IVUS and 2D-TEE, and compared with MDCT in 50 patients undergoing TAVR. The IVUS and MDCT annular areas and diameters were not significantly different (446 ± 87 mm2 and 23.8 ± 84 mm vs. 466 ± 84 mm2 and 24 ± 2.1 mm, respectively; P > 0.05). IVUS and MDCT mean annular diameters were significantly greater than TEE diameter (23.8 ± 2.4 and 24 ± 2.1 vs. 22 ± 0.65 mm, respectively; P |
| doi_str_mv | 10.1093/ehjci/jew322 |
| format | Article |
| fullrecord | <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_ehjci_jew322</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ehjci/jew322</oup_id><sourcerecordid>10.1093/ehjci/jew322</sourcerecordid><originalsourceid>FETCH-LOGICAL-c361t-3fd6646d3f6d136955398b7854075622348c049aa12cc299201cc10311a97c043</originalsourceid><addsrcrecordid>eNp9kUtLxDAUhYMoKjo715KdG-vk1bR1J-ILBgQZ3ZaYpG2GtilJ6qB_0L9lOjO6NJubc--XewIHgDOMrjAq6Fw3K2nmK72mhOyBY4JYlhCGyf7fHbEjMPN-heJJGWcEH4IjkmOeYlIcg--FcLVOKqNbBU0fnPgQXo6tcHBso_J27BWsrIOi7zdtb75MX0ep4OC0MjJMchDTy_Zjgzhdj642QQRje6hGNxHLm7eXayhtF1Hjbe_h2oQGdtHGKB20DNFkGo9BKxhsZ2snhuZz4xR_0nurvR0aUWvRQi0bK4VTZkedgoNKtF7PdvUEvN7fLW8fk8Xzw9PtzSKRlOOQ0EpxzriiFVeY8iJNaZG_Z3nKUJZyQijLJWKFEJhISYqCICwlRhRjUWRxQk_A5XavdNZ7p6tycKYT7rPEqJwiKTeRlNtIIn6-xYfxvdPqD_4NIAIXW8COw_-rfgCH7Zyr</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Large-field intravascular ultrasound for annular sizing and predicting paravalvular regurgitation during TAVR: comparisons with multidetector computed tomography and transoesophageal echocardiography</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Hakim, Diaa ; Ghimire, Gopal ; Alli, Oluseun O ; Singh, Satinder ; Sasse, Mark F ; Booker, Oscar J ; Arora, Garima ; Leesar, Tara ; Jernigan, Lindsey ; Melby, Spencer J ; Davies, James E ; Leesar, Massoud A</creator><creatorcontrib>Hakim, Diaa ; Ghimire, Gopal ; Alli, Oluseun O ; Singh, Satinder ; Sasse, Mark F ; Booker, Oscar J ; Arora, Garima ; Leesar, Tara ; Jernigan, Lindsey ; Melby, Spencer J ; Davies, James E ; Leesar, Massoud A</creatorcontrib><description>Abstract
Aims
The use of contrast media with multidetector computed tomography (MDCT) may induce acute kidney injury in patients with renal failure undergoing transcatheter aortic valve replacement (TAVR). We investigated the role of large-field intravascular ultrasound (IVUS) vs. MDCT and two-dimensional transoesophageal echocardiography (2D-TEE) for annular sizing and predicting paravalvular regurgitation (PVR) during TAVR.
Methods and Results
The aortic annulus was measured by large-field IVUS and 2D-TEE, and compared with MDCT in 50 patients undergoing TAVR. The IVUS and MDCT annular areas and diameters were not significantly different (446 ± 87 mm2 and 23.8 ± 84 mm vs. 466 ± 84 mm2 and 24 ± 2.1 mm, respectively; P > 0.05). IVUS and MDCT mean annular diameters were significantly greater than TEE diameter (23.8 ± 2.4 and 24 ± 2.1 vs. 22 ± 0.65 mm, respectively; P < 0.01). PVR ≥ Mild occurred in 13 patients (26%); 5 patients required post-dilation and 2 patients a second valve. Receiver operating characteristic analyses showed that transcatheter heart valve (THV) area − IVUS or MDCT areas equally predicted of ≥ mild PVR (areas under the curve [AUC] 0.79 and 0.81, respectively; P < 0.001), and were greater than THV diameter-TEE diameter (AUC 0.79 and 0.81 vs. 0.56, respectively; P < 0.05).
Conclusions
The aortic annular measurements and predicting PVR by large field IVUS were not significantly different from those of MDCT, but were greater than those of TEE. Large filed IVUS can be reliably used in lieu of MDCT for annular sizing in patients with aortic stenosis and renal failure or suboptimal MDCT images.</description><identifier>ISSN: 2047-2404</identifier><identifier>EISSN: 2047-2412</identifier><identifier>DOI: 10.1093/ehjci/jew322</identifier><identifier>PMID: 28165129</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Analysis of Variance ; Aortic Valve Insufficiency - diagnostic imaging ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - surgery ; Area Under Curve ; Chi-Square Distribution ; Cohort Studies ; Echocardiography, Transesophageal - methods ; Female ; Humans ; Intraoperative Complications - diagnostic imaging ; Male ; Multidetector Computed Tomography - methods ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Risk Assessment ; ROC Curve ; Severity of Illness Index ; Transcatheter Aortic Valve Replacement - adverse effects ; Transcatheter Aortic Valve Replacement - methods ; Treatment Outcome ; Ultrasonography, Interventional - methods</subject><ispartof>European heart journal cardiovascular imaging, 2017-12, Vol.18 (12), p.1404-1413</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com. 2017</rights><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-3fd6646d3f6d136955398b7854075622348c049aa12cc299201cc10311a97c043</citedby><cites>FETCH-LOGICAL-c361t-3fd6646d3f6d136955398b7854075622348c049aa12cc299201cc10311a97c043</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28165129$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hakim, Diaa</creatorcontrib><creatorcontrib>Ghimire, Gopal</creatorcontrib><creatorcontrib>Alli, Oluseun O</creatorcontrib><creatorcontrib>Singh, Satinder</creatorcontrib><creatorcontrib>Sasse, Mark F</creatorcontrib><creatorcontrib>Booker, Oscar J</creatorcontrib><creatorcontrib>Arora, Garima</creatorcontrib><creatorcontrib>Leesar, Tara</creatorcontrib><creatorcontrib>Jernigan, Lindsey</creatorcontrib><creatorcontrib>Melby, Spencer J</creatorcontrib><creatorcontrib>Davies, James E</creatorcontrib><creatorcontrib>Leesar, Massoud A</creatorcontrib><title>Large-field intravascular ultrasound for annular sizing and predicting paravalvular regurgitation during TAVR: comparisons with multidetector computed tomography and transoesophageal echocardiography</title><title>European heart journal cardiovascular imaging</title><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><description>Abstract
Aims
The use of contrast media with multidetector computed tomography (MDCT) may induce acute kidney injury in patients with renal failure undergoing transcatheter aortic valve replacement (TAVR). We investigated the role of large-field intravascular ultrasound (IVUS) vs. MDCT and two-dimensional transoesophageal echocardiography (2D-TEE) for annular sizing and predicting paravalvular regurgitation (PVR) during TAVR.
Methods and Results
The aortic annulus was measured by large-field IVUS and 2D-TEE, and compared with MDCT in 50 patients undergoing TAVR. The IVUS and MDCT annular areas and diameters were not significantly different (446 ± 87 mm2 and 23.8 ± 84 mm vs. 466 ± 84 mm2 and 24 ± 2.1 mm, respectively; P > 0.05). IVUS and MDCT mean annular diameters were significantly greater than TEE diameter (23.8 ± 2.4 and 24 ± 2.1 vs. 22 ± 0.65 mm, respectively; P < 0.01). PVR ≥ Mild occurred in 13 patients (26%); 5 patients required post-dilation and 2 patients a second valve. Receiver operating characteristic analyses showed that transcatheter heart valve (THV) area − IVUS or MDCT areas equally predicted of ≥ mild PVR (areas under the curve [AUC] 0.79 and 0.81, respectively; P < 0.001), and were greater than THV diameter-TEE diameter (AUC 0.79 and 0.81 vs. 0.56, respectively; P < 0.05).
Conclusions
The aortic annular measurements and predicting PVR by large field IVUS were not significantly different from those of MDCT, but were greater than those of TEE. Large filed IVUS can be reliably used in lieu of MDCT for annular sizing in patients with aortic stenosis and renal failure or suboptimal MDCT images.</description><subject>Analysis of Variance</subject><subject>Aortic Valve Insufficiency - diagnostic imaging</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Area Under Curve</subject><subject>Chi-Square Distribution</subject><subject>Cohort Studies</subject><subject>Echocardiography, Transesophageal - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Intraoperative Complications - diagnostic imaging</subject><subject>Male</subject><subject>Multidetector Computed Tomography - methods</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>ROC Curve</subject><subject>Severity of Illness Index</subject><subject>Transcatheter Aortic Valve Replacement - adverse effects</subject><subject>Transcatheter Aortic Valve Replacement - methods</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Interventional - methods</subject><issn>2047-2404</issn><issn>2047-2412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtLxDAUhYMoKjo715KdG-vk1bR1J-ILBgQZ3ZaYpG2GtilJ6qB_0L9lOjO6NJubc--XewIHgDOMrjAq6Fw3K2nmK72mhOyBY4JYlhCGyf7fHbEjMPN-heJJGWcEH4IjkmOeYlIcg--FcLVOKqNbBU0fnPgQXo6tcHBso_J27BWsrIOi7zdtb75MX0ep4OC0MjJMchDTy_Zjgzhdj642QQRje6hGNxHLm7eXayhtF1Hjbe_h2oQGdtHGKB20DNFkGo9BKxhsZ2snhuZz4xR_0nurvR0aUWvRQi0bK4VTZkedgoNKtF7PdvUEvN7fLW8fk8Xzw9PtzSKRlOOQ0EpxzriiFVeY8iJNaZG_Z3nKUJZyQijLJWKFEJhISYqCICwlRhRjUWRxQk_A5XavdNZ7p6tycKYT7rPEqJwiKTeRlNtIIn6-xYfxvdPqD_4NIAIXW8COw_-rfgCH7Zyr</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Hakim, Diaa</creator><creator>Ghimire, Gopal</creator><creator>Alli, Oluseun O</creator><creator>Singh, Satinder</creator><creator>Sasse, Mark F</creator><creator>Booker, Oscar J</creator><creator>Arora, Garima</creator><creator>Leesar, Tara</creator><creator>Jernigan, Lindsey</creator><creator>Melby, Spencer J</creator><creator>Davies, James E</creator><creator>Leesar, Massoud A</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20171201</creationdate><title>Large-field intravascular ultrasound for annular sizing and predicting paravalvular regurgitation during TAVR: comparisons with multidetector computed tomography and transoesophageal echocardiography</title><author>Hakim, Diaa ; Ghimire, Gopal ; Alli, Oluseun O ; Singh, Satinder ; Sasse, Mark F ; Booker, Oscar J ; Arora, Garima ; Leesar, Tara ; Jernigan, Lindsey ; Melby, Spencer J ; Davies, James E ; Leesar, Massoud A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-3fd6646d3f6d136955398b7854075622348c049aa12cc299201cc10311a97c043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Analysis of Variance</topic><topic>Aortic Valve Insufficiency - diagnostic imaging</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Area Under Curve</topic><topic>Chi-Square Distribution</topic><topic>Cohort Studies</topic><topic>Echocardiography, Transesophageal - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Intraoperative Complications - diagnostic imaging</topic><topic>Male</topic><topic>Multidetector Computed Tomography - methods</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>ROC Curve</topic><topic>Severity of Illness Index</topic><topic>Transcatheter Aortic Valve Replacement - adverse effects</topic><topic>Transcatheter Aortic Valve Replacement - methods</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Interventional - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hakim, Diaa</creatorcontrib><creatorcontrib>Ghimire, Gopal</creatorcontrib><creatorcontrib>Alli, Oluseun O</creatorcontrib><creatorcontrib>Singh, Satinder</creatorcontrib><creatorcontrib>Sasse, Mark F</creatorcontrib><creatorcontrib>Booker, Oscar J</creatorcontrib><creatorcontrib>Arora, Garima</creatorcontrib><creatorcontrib>Leesar, Tara</creatorcontrib><creatorcontrib>Jernigan, Lindsey</creatorcontrib><creatorcontrib>Melby, Spencer J</creatorcontrib><creatorcontrib>Davies, James E</creatorcontrib><creatorcontrib>Leesar, Massoud A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>European heart journal cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hakim, Diaa</au><au>Ghimire, Gopal</au><au>Alli, Oluseun O</au><au>Singh, Satinder</au><au>Sasse, Mark F</au><au>Booker, Oscar J</au><au>Arora, Garima</au><au>Leesar, Tara</au><au>Jernigan, Lindsey</au><au>Melby, Spencer J</au><au>Davies, James E</au><au>Leesar, Massoud A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Large-field intravascular ultrasound for annular sizing and predicting paravalvular regurgitation during TAVR: comparisons with multidetector computed tomography and transoesophageal echocardiography</atitle><jtitle>European heart journal cardiovascular imaging</jtitle><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>18</volume><issue>12</issue><spage>1404</spage><epage>1413</epage><pages>1404-1413</pages><issn>2047-2404</issn><eissn>2047-2412</eissn><abstract>Abstract
Aims
The use of contrast media with multidetector computed tomography (MDCT) may induce acute kidney injury in patients with renal failure undergoing transcatheter aortic valve replacement (TAVR). We investigated the role of large-field intravascular ultrasound (IVUS) vs. MDCT and two-dimensional transoesophageal echocardiography (2D-TEE) for annular sizing and predicting paravalvular regurgitation (PVR) during TAVR.
Methods and Results
The aortic annulus was measured by large-field IVUS and 2D-TEE, and compared with MDCT in 50 patients undergoing TAVR. The IVUS and MDCT annular areas and diameters were not significantly different (446 ± 87 mm2 and 23.8 ± 84 mm vs. 466 ± 84 mm2 and 24 ± 2.1 mm, respectively; P > 0.05). IVUS and MDCT mean annular diameters were significantly greater than TEE diameter (23.8 ± 2.4 and 24 ± 2.1 vs. 22 ± 0.65 mm, respectively; P < 0.01). PVR ≥ Mild occurred in 13 patients (26%); 5 patients required post-dilation and 2 patients a second valve. Receiver operating characteristic analyses showed that transcatheter heart valve (THV) area − IVUS or MDCT areas equally predicted of ≥ mild PVR (areas under the curve [AUC] 0.79 and 0.81, respectively; P < 0.001), and were greater than THV diameter-TEE diameter (AUC 0.79 and 0.81 vs. 0.56, respectively; P < 0.05).
Conclusions
The aortic annular measurements and predicting PVR by large field IVUS were not significantly different from those of MDCT, but were greater than those of TEE. Large filed IVUS can be reliably used in lieu of MDCT for annular sizing in patients with aortic stenosis and renal failure or suboptimal MDCT images.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>28165129</pmid><doi>10.1093/ehjci/jew322</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Analysis of Variance Aortic Valve Insufficiency - diagnostic imaging Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - surgery Area Under Curve Chi-Square Distribution Cohort Studies Echocardiography, Transesophageal - methods Female Humans Intraoperative Complications - diagnostic imaging Male Multidetector Computed Tomography - methods Predictive Value of Tests Prognosis Prospective Studies Risk Assessment ROC Curve Severity of Illness Index Transcatheter Aortic Valve Replacement - adverse effects Transcatheter Aortic Valve Replacement - methods Treatment Outcome Ultrasonography, Interventional - methods |
| title | Large-field intravascular ultrasound for annular sizing and predicting paravalvular regurgitation during TAVR: comparisons with multidetector computed tomography and transoesophageal echocardiography |
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