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3-Dimensional Echocardiographic Prediction of Left Ventricular Outflow Tract Area Prior to Transcatheter Mitral Valve Replacement.
Bartkowiak, Joanna; Dernektsi, Chrisoula; Agarwal, Vratika; Lebehn, Mark A; Williams, Treena A; Brandwein, Russel A; Brugger, Nicolas; Gräni, Christoph; Windecker, Stephan; Vahl, Torsten P; Nazif, Tamim M; George, Isaac; Kodali, Susheel K; Praz, Fabien; Hahn, Rebecca T.
Afiliación
  • Bartkowiak J; Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
  • Dernektsi C; Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
  • Agarwal V; Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
  • Lebehn MA; Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
  • Williams TA; Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
  • Brandwein RA; Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
  • Brugger N; Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
  • Gräni C; Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
  • Windecker S; Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
  • Vahl TP; Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
  • Nazif TM; Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
  • George I; Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
  • Kodali SK; Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
  • Praz F; Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
  • Hahn RT; Department of Medicine, The New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA. Electronic address: rth2@columbia.edu.
JACC Cardiovasc Imaging ; 2024 Jul 11.
Article en En | MEDLINE | ID: mdl-39066744
ABSTRACT

BACKGROUND:

New postprocessing software facilitates 3-dimensional (3D) echocardiographic determination of mitral annular (MA) and neo-left ventricular outflow tract (neo-LVOT) dimensions in patients undergoing transcatheter mitral valve replacement (TMVR).

OBJECTIVES:

This study aims to test the accuracy of 3D echocardiographic analysis as compared to baseline computed tomography (CT).

METHODS:

A total of 105 consecutive patients who underwent TMVR at 2 tertiary care centers between October 2017 and May 2023 were retrospectively included. A virtual valve was projected in both baseline CT and 3D transesophageal echocardiography (TEE) using dedicated software. MA dimensions were measured in baseline images and neo-LVOT dimensions were measured in baseline and postprocedural images. All measurements were compared to baseline CT as a reference. The predicted neo-LVOT area was correlated with postprocedural peak LVOT gradients.

RESULTS:

There was no significant bias in baseline neo-LVOT prediction between both imaging modalities. TEE significantly underestimated MA area, perimeter, and medial-lateral dimension compared to CT. Both modalities significantly underestimated the actual neo-LVOT area (mean bias pre/post TEE 25.6 mm2, limit of agreement -92.2 mm2 to 143.3 mm2; P < 0.001; mean bias pre/post CT 28.3 mm2, limit of agreement -65.8 mm2 to 122.4 mm2; P = 0.046), driven by neo-LVOT underestimation in the group treated with dedicated mitral valve bioprosthesis. Both CT- and TEE-predicted-neo-LVOT areas exhibited an inverse correlation with postprocedural LVOT gradients (r2 = 0.481; P < 0.001 for TEE and r2 = 0.401; P < 0.001 for CT).

CONCLUSIONS:

TEE-derived analysis provides comparable results with CT-derived metrics in predicting the neo-LVOT area and peak gradient after TMVR.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JACC Cardiovasc Imaging Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JACC Cardiovasc Imaging Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Estados Unidos