Comparison of multislice computed tomography findings between bicuspid and tricuspid aortic valves before and after transcatheter aortic valve implantation. Issue 2 (17th February 2015)

• Record Type: Journal Article
• Authors: Watanabe, Yusuke; Chevalier, Bernard; Hayashida, Kentaro; Leong, Tora; Bouvier, Erik; Arai, Takahide; Farge, Arnaud; Hovasse, Thomas; Garot, Philippe; Cormier, Bertrand; Morice, Marie‐Claude; Lefèvre, Thierry
• Is Part Of: Catheterization and cardiovascular interventions. Volume 86:Issue 2(2015:Aug. 01)
• Page Start: 323
• Page End: 330
• Publication Date: 2015-02-17
• Subjects: transcatheter aortic valve implantation -- bicuspid aortic valve -- multislice computed tomography; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25830
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract : Aims: This study sought to compare the multislice computed tomography (MSCT) characteristics of bicuspid aortic valves (BAV) and tricuspid aortic valves (TAV) before and after implantation of the CoreValve (Medtronic, Santa Rosa, California) or the Edwards SapienXT (Edwards Lifesciences, Irvine, CA). Methods and Results: From March 2009 to March 2013, a total of 67 TAVI patients who had both pre‐ and post‐procedural MSCT were studied. Eleven patients underwent TAVI in BAV with the CoreValve ( n = 6) or SapienXT ( n = 5) and 56 patients underwent TAVI in TAV with the CoreValve ( n = 38) or SapienXT ( n = 18). The BAV group was similar to the TAV group except for a higher pre‐procedural mean pressure gradient (53.1 ± 17.4 vs. 48.8 ± 20.4 mm Hg, P = 0.03), a larger annulus perimeter (89.3 ± 9.0 vs. 81.8 ± 8.1 mm, P = 0.03) and a higher aortic valve calcium volume (1262.7 ± 396.0 vs. 556.4 ± 461.9 mm 3, P < 0.01). In the CoreValve group, post‐procedural mean pressure gradient was significantly higher in the BAV group (11.0 ± 2.6 vs. 8.2 ± 2.8 mm Hg, P = 0.04) and a smaller valve area/pre‐annulus area ratio was observed at each level of the prosthesis (base of the stent frame 81.7% ± 14.9% vs. 94.7% ± 15.0%, P = 0.06, annulus level 74.3% ± 16.7% vs. 89.9% ± 10.5%, P = 0.03, leaflet level 64.6% ± 13.1% vs. 81.2% ± 13.2%, P < 0.01). This was not observed in the Edwards group. Conclusions: Compared to TAV, patients with BAV have higher gradients, larger annulus perimeters and more calcified valves. Higher post procedural gradient and valve underexpansion were frequently observed after CoreValve implantation. Further MSCT study is required to demonstrate the efficacy of TAVI in BAV. © 2015 Wiley Periodicals, Inc.