Title
Aortic regurgitation after transcatheter aortic valve implantation (TAVI) : angiographic, echocardiographic and hemodynamic assessment in relation to one year outcome Aortic regurgitation after transcatheter aortic valve implantation (TAVI) : angiographic, echocardiographic and hemodynamic assessment in relation to one year outcome
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Amsterdam ,
Subject
Human medicine
Source (journal)
International journal of cardiology. - Amsterdam, 1981, currens
Volume/pages
194(2015) , p. 13-20
ISSN
0167-5273
ISI
000356053900004
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Background Aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) remains a relatively frequent and life-limiting complication. However, the most prognostically discriminative (and therefore preferred) technique of AR evaluation after TAVI is not yet clearly defined. The aim of this study was to compare angiographic, echocardiographic and hemodynamic assessment of AR after TAVI in relation to one year outcome. Methods and results In this single center prospective cohort study, angiography (AR grading), echocardiography (AR quantification using color Doppler flow mapping) and invasive hemodynamics (AR index) were assessed before and after TAVI. All patients were followed up to at least one year. A total of 111 consecutive (very) high-risk patients with severe, symptomatic aortic valve stenosis underwent TAVI. No concordant relation could be demonstrated between angiographic, echocardiographic and invasive assessment of AR after TAVI. AR index < 25 post TAVI was significantly influenced by left ventricular posterior wall thickness (odds ratio: 1.276, p = 0.030) and AR index pre TAVI (odds ratio: 0.948, p = 0.019). Neither angiographic nor hemodynamic AR assessments were able to discriminate between good or significantly decreased one year survival. In contrast, color Doppler flow mapping of AR after TAVI was highly reproducible, and able to differentiate between good or significantly decreased one year survival (AR grades 0I: one year survival 87% vs. AR grades IIIIIIV: one year survival 68%, p = 0.035). Conclusion Echocardiography using color Doppler flow mapping is the preferred technique to assess prognostically relevant AR after TAVI.
E-info
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