Noninvasive Evaluation of the Aortic Root With Multislice Computed Tomography : Implications for Transcatheter Aortic Valve Replacement
Laurens F. Tops,David A. Wood,Victoria Delgado,Joanne D. Schuijf,John R. Mayo,Sanjeevan Pasupati,Frouke P.L. Lamers,Ernst E. van der Wall,Martin J. Schalij,John G. Webb,Jeroen J. Bax +10 more
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The anatomy of the aortic root was assessed noninvasively with multislice computed tomography (MSCT) and the MSCT may be helpful for avoiding paravalvular leakage and coronary occlusion and may facilitate the selection of candidates for transcatheter aortsic valve replacement.Abstract:
Objectives In the present study, the anatomy of the aortic root was assessed noninvasively with multislice computed tomography (MSCT). Background Transcatheter aortic valve replacement has been proposed as an alternative to surgery in high-risk patients with severe aortic stenosis. For this procedure, detailed knowledge of aortic annulus diameters and the relation between the annulus and the coronary arteries is needed. Methods In 169 patients (111 men, age 54 ± 11 years), a 64-slice MSCT scan was performed for evaluation of coronary artery disease. Of these, 150 patients had no or mild aortic stenosis, and 19 patients had moderate to severe aortic stenosis. Reconstructed coronal and sagittal views were used for assessment of the aortic annulus diameter in 2 directions. In addition, the distance between the annulus and the ostium of the right and left coronary arteries and the length of the coronary leaflets were assessed. The LV outflow tract and interventricular septum were analyzed on the single oblique sagittal view at end-diastole. Results The diameter of the aortic annulus was 26.3 ± 2.8 mm on the coronal view, and 23.5 ± 2.7 mm on the sagittal view. Mean difference between the 2 diameters was 2.9 ± 1.8 mm, indicating an oval shape of the aortic annulus. Mean distance between the aortic annulus and the ostium of the right coronary artery was 17.2 ± 3.3 mm, and mean distance between the annulus and the ostium of the left coronary artery was 14.4 ± 2.9 mm. In 82 patients (49%), the length of the left coronary leaflet exceeded the distance between the annulus and the ostium of the left coronary artery. There were no significant differences in the diameter of annulus, diameter of sinus of Valsalva, or the distance between the annulus, left coronary leaflet, and the ostium of the left coronary artery, between the patient with and without severe aortic stenosis. Conclusions The MSCT can provide detailed information on the shape of the aortic annulus and the relation between the annulus and the ostia of the coronary arteries. Thereby, MSCT may be helpful for avoiding paravalvular leakage and coronary occlusion and may facilitate the selection of candidates for transcatheter aortic valve replacement.read more
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Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.
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Two-Year Outcomes after Transcatheter or Surgical Aortic-Valve Replacement
Susheel Kodali,Mathew R. Williams,Craig R. Smith,Lars G. Svensson,John G. Webb,Raj Makkar,Gregory P. Fontana,Todd M. Dewey,Vinod H. Thourani,Augusto D. Pichard,Michael P. Fischbein,Wilson Y. Szeto,Scott Lim,Kevin L. Greason,Paul S. Teirstein,S. Chris Malaisrie,Pamela S. Douglas,Rebecca T. Hahn,Brian Whisenant,Alan Zajarias,Duolao Wang,Jodi J. Akin,William N. Anderson,Martin B. Leon,Trial Investigators +24 more
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Alec Vahanian,Ottavio Alfieri,Nawwar Al-Attar,Manuel J. Antunes,Jeroen Bax,Bertrand Cormier,Alain Cribier,Peter De Jaegere,Gerard Fournial,Arie Pieter Kappetein,Jan Kovac,Susanne Ludgate,Francesco Maisano,Neil Moat,Friedrich W. Mohr,Patrick Nataf,Luc Pierard,José Luis Pomar,Joachim Schofer,Pilar Tornos,Murat Tuzcu,Ben van Hout,Ludwig K. von Segesser,Thomas Walther +23 more
TL;DR: Transcatheter aortic valve implantation is a promising technique, which may offer an alternative to conventional surgery for high-risk patients with aorta stenosis and may be extended to lower risk patients if the initial promise holds to be true after careful evaluation.
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2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement
David R. Holmes,Michael J. Mack,Sanjay Kaul,Arvind K. Agnihotri,Karen P. Alexander,Steven R. Bailey,John H. Calhoon,Blase A. Carabello,Milind Y. Desai,Fred H. Edwards,Gary S. Francis,Timothy J. Gardner,A. Pieter Kappetein,Jane A. Linderbaum,Chirojit Mukherjee,Debabrata Mukherjee,Catherine M Otto,Carlos E. Ruiz,Ralph L. Sacco,Donnette Smith,James D. Thomas +20 more
TL;DR: The 2017-18 FACC curriculum was designed to foster an environment that fosters a positive view of the profession and promotes a positive attitude towards individuals and the profession.
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Anatomy of the Aortic Valvar Complex and Its Implications for Transcatheter Implantation of the Aortic Valve
Nicolo Piazza,Peter de Jaegere,Carl Schultz,Anton E. Becker,Patrick W. Serruys,Robert H. Anderson +5 more
TL;DR: The anatomy of the trifoliate aortic valvar complex is described and its implications for percutaneous valvar replacement are described.
References
More filters
Journal ArticleDOI
ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease
Robert O. Bonow,Blase A. Carabello,Kanu Chatterjee,Antonio C. de Leon,David P. Faxon,Michael D. Freed,William H. Gaasch,Bruce W. Lytle,Rick A. Nishimura,Patrick T. O'Gara,Robert A. O'Rourke,Catherine M Otto,Pravin M. Shah,Jack S. Shanewise +13 more
TL;DR: It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced in the detection, management, and management of diseases.
Journal ArticleDOI
Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms.
Nelson B. Schiller,P. M. Shah,Michael H. Crawford,Anthony N. DeMaria,Richard B. Devereux,Harvey Feigenbaum,H. Gutgesell,Nathaniel Reichek,David J. Sahn,Ingela Schnittger +9 more
TL;DR: It is the opinion that current technology justifies the clinical use of the quantitative two-dimensional methods described in this article and the routine reporting of left ventricular ejection fraction, diastolic volume, mass, and wall motion score.
Journal ArticleDOI
Quantification of coronary artery calcium using ultrafast computed tomography
Arthur S. Agatston,Warren R. Janowitz,Warren R. Janowitz,Frank J. Hildner,Frank J. Hildner,N R Zusmer,N R Zusmer,Manuel Viamonte,Manuel Viamonte,Robert Detrano,Robert Detrano +10 more
TL;DR: In this article, the authors used ultrafast computed tomography (UCT) to detect and quantify coronary artery calcium levels in 584 subjects (mean age 48 +/- 10 years) with and without clinical coronary artery disease.
Journal ArticleDOI
A prospective survey of patients with valvular heart disease in Europe : The Euro Heart Survey on Valvular Heart Disease.
Bernard Iung,Gabriel Baron,Eric G. Butchart,François Delahaye,Christa Gohlke-Bärwolf,Olaf W. Levang,Pilar Tornos,Jean-Louis Vanoverschelde,Frank Vermeer,Eric Boersma,Philippe Ravaud,Alec Vahanian +11 more
TL;DR: Degenerative aetiologies were the most frequent in aortic VHD and mitral regurgitation while most cases of mitral stenosis were of rheumatic origin.
Journal ArticleDOI
ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease)
Robert O. Bonow,Blase A. Carabello,Kanu Chatterjee,Antonio C. de Leon,David P. Faxon,Michael D. Freed,William H. Gaasch,Bruce W. Lytle,Rick A. Nishimura,Patrick T. O'Gara,Robert A. O'Rourke,Catherine M Otto,Pravin M. Shah,Jack S. Shanewise,Sidney C. Smith,Alice K. Jacobs,Cynthia D. Adams,Jeffrey L. Anderson,Elliott M. Antman,Valentin Fuster,Jonathan L. Halperin,Loren F. Hiratzka,Sharon A. Hunt,Bruce W. Lytle,Rick A. Nishimura,Richard L. Page,Barbara Riegel +26 more
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