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Transcatheter Aortic Valve Replacement

Abstract

Recommended Article

Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients Coronary Access After TAVR Relationship Between Hospital Surgical Aortic Valve Replacement Volume and Transcatheter Aortic Valve Replacement Outcomes Risk of Coronary Obstruction and Feasibility of Coronary Access After Repeat Transcatheter Aortic Valve Replacement With the Self-Expanding Evolut Valve: A Computed Tomography Simulation Study Informed Shared Decisions for Patients with Aortic Stenosis Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Valve Stenosis: 1-Year Results From the All-Comers NOTION Randomized Clinical Trial Transcatheter and surgical aortic valve replacement in patients with bicuspid aortic valve Coronary Protection to Prevent Coronary Obstruction During TAVR: A Multicenter International Registry
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Original Research2021 Feb 2;S1936-8798(20)32281-0.

JOURNAL：JACC Cardiovasc Interv. Article Link

Online Quantitative Aortographic Assessment of Aortic Regurgitation After TAVR: Results of the OVAL Study

R Modolo, M van Mourik, PW Serruys et al. Keywords: TAVR; aortic regurgitation; paravalvular leak

ABSTRACT

BACKGROUND - Quantitative assessment of regurgitation after TAVR through aortography using videodensitometry is simple, reproducible, and validated in vitro, in vivo, in clinical trials, and in “real-world” patients. However, thus far the assessment has been done offline.

 

METHODS - This was a single center, prospective, proof-of-principle, feasibility study. One hundred consecutive patients with aortic stenosis and indications to undergo TAVR were enrolled. All final aortograms were analyzed immediately after acquisition in the catheterization laboratory and were also sent to an independent core laboratory for blinded offline assessment. The primary endpoint of the study was the feasibility of the online assessment of regurgitation (percentage of analyzable cases). The secondary endpoint was the reproducibility of results between the online assessment and the offline analysis by the core laboratory.

 

RESULTS - Patients’ mean age was 81 ± 7 years, and 56% were men. The implanted valves were either SAPIEN 3 (97%) or SAPIEN 3 Ultra (3%). The primary endpoint of online feasibility of analysis was 92% (95% confidence interval [CI]: 86% to 97%) which was the same feasibility encountered by the core laboratory (92%; 95% CI: 86% to 97%). Reproducibility assessment showed a high correlation between online and core laboratory evaluations (R2 = 0.87, p < 0.001), with an intraclass correlation coefficient of 0.962 (95% CI: 0.942 to 0.975; p < 0.001).

 

CONCLUSIONS - This study showed high feasibility of online quantitative assessment of regurgitation and high agreement between the online examiner and core laboratory. These results may pave the way for the application of videodensitometry in the catheterization laboratory after TAVR. (Online Videodensitometric Assessment of Aortic Regurgitation in the Cath-Lab [OVAL]; NCT04047082)

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