RT Journal Article
T1 Prosthesis/annulus discongruence assessed by three-dimensional transoesophageal echocardiography: A predictor of significant paravalvular aortic regurgitation after transcatheter aortic valve implantation
A1 Santos, Ninel
A1 De Agustín Loeches, José Alberto
A1 Hernández Antolín, Rosa Ana
A1 Pérez De Isla, Leopoldo
A1 Macaya Miguel, Carlos
A1 Zamorano Gómez, José Luis
AB AimsParavalvular aortic regurgitation (AR) is common after transcatheter aortic valve implantation (TAVI). This study aimed to assess the prosthesis/aortic annulus discongruence by three-dimensional (3D) transoesophageal (TOE) planimetry of aortic annulus and its impact on the occurrence of significant AR after TAVI.Methods and resultsWe included 33 patients who underwent TAVI with a balloon expandable device for severe aortic stenosis. To appraise the prosthesis/annulus discongruence, we defined a ‘mismatch index’ expressed as: annulus area − prosthesis area. The aortic annulus area was planimetered with 3D TOE, and approximated by circular area formula (π r2) using annulus diameter obtained by two-dimensional (2D) TOE. After TAVI, 13 patients (39.3%) developed significant AR (≥2/4). The occurrence of significant AR was associated to the 3D planimetered annulus area (P = 0.04), and the ‘mismatch index’ obtained through 3D planimetered annulus area (P = 0.03), but not to ‘mismatch index’ derived of 2D annulus diameter. In multivariate analysis, ‘mismatch index’ for 3D planimetered annulus area was the only independent predictor of significant AR (odds ratio: 10.614; 95% CI: 1.044–17.21; P = 0.04). The area under the receiver operating characteristic curve for the ‘mismatch index’ by the 3D planimetered annulus area was 0.76 (95% CI: 0.54–0.92), whereas for ‘mismatch index’ obtained by the 2D circular area was 0.36 (95% CI: 0.17–0.55). Using the 3D planimetered annulus area as the reference parameter to decide the prosthetic size, the choice would have been different in 21 patients (63%).ConclusionThree-dimensional TOE planimetry of aortic annulus improves the assessment of prosthesis/annulus discongruence and predicts the appearance of significant AR after TAVI.
PB Elsevier
YR 2012
FD 2012-04-17
LK https://hdl.handle.net/20.500.14352/131931
UL https://hdl.handle.net/20.500.14352/131931
LA eng
NO Santos, N., de Agustín, J. A., Almería, C., Gonçalves, A., Marcos-Alberca, P., Fernández-Golfín, C., García, E., Hernández-Antolín, R., de Isla, L. P., Macaya, C., & Zamorano, J. (2012). Prosthesis/annulus discongruence assessed by three-dimensional transoesophageal echocardiography: a predictor of significant paravalvular aortic regurgitation after transcatheter aortic valve implantation. European heart journal. Cardiovascular Imaging, 13(11), 931–937. https://doi.org/10.1093/ehjci/jes072
DS Docta Complutense
RD 22 mar 2026