Comparison of multislice computed tomography findings between bicuspid and tricuspid aortic valves before and after transcatheter aortic valve implantation

Yusuke Watanabe, Bernard Chevalier, Kentaro Hayashida, Tora Leong, Erik Bouvier, Takahide Arai, Arnaud Farge, Thomas Hovasse, Philippe Garot, Bertrand Cormier, Marie Claude Morice, Thierry Lefèvre

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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<sup>3</sup>, 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.

Original languageEnglish
Pages (from-to)323-330
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume86
Issue number2
DOIs
Publication statusPublished - 2015 Aug 1

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Keywords

  • bicuspid aortic valve
  • multislice computed tomography
  • transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Watanabe, Y., Chevalier, B., Hayashida, K., Leong, T., Bouvier, E., Arai, T., Farge, A., Hovasse, T., Garot, P., Cormier, B., Morice, M. C., & Lefèvre, T. (2015). Comparison of multislice computed tomography findings between bicuspid and tricuspid aortic valves before and after transcatheter aortic valve implantation. Catheterization and Cardiovascular Interventions, 86(2), 323-330. https://doi.org/10.1002/ccd.25830