Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement

Mahmoud Abdelshafy; Patrick W Serruys; Tsung-Ying Tsai; Pruthvi Chenniganahosahalli Revaiah; Scot Garg; Jean-Paul Aben; Carl J Schultz; Mohammad Abdelghani; Pim A L Tonino; Yosuke Miyazaki; Marcel C M Rutten; Martijn Cox; Cherif Sahyoun; Justin Teng; Hiroki Tateishi; Mohamed Abdel-Wahab; Nicolo Piazza; Michele Pighi; Rodrigo Modolo; Martijn van Mourik; Joanna Wykrzykowska; Robbert J de Winter; Pedro A Lemos; Fábio S de Brito; Hideyuki Kawashima; Lars Søndergaard; Liesbeth Rosseel; Rutao Wang; Chao Gao; Ling Tao; Andreas Rück; Won-Keun Kim; Niels van Royen; Christian J Terkelsen; Henrik Nissen; Matti Adam; Tanja K Rudolph; Hendrik Wienemann; Ryo Torii; Franz Josef Neuman; Simon Schoechlin; Mao Chen; Ahmed Elkoumy; Hesham Elzomor; Ignacio J Amat-Santos; Darren Mylotte; Osama Soliman; Yoshinobu Onuma

doi:10.3389/fcvm.2023.1161779

Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement

Mahmoud Abdelshafy, Patrick W Serruys^*, Tsung-Ying Tsai, Pruthvi Chenniganahosahalli Revaiah, Scot Garg, Jean-Paul Aben, Carl J Schultz, Mohammad Abdelghani, Pim A L Tonino, Yosuke Miyazaki, Marcel C M Rutten, Martijn Cox, Cherif Sahyoun, Justin Teng, Hiroki Tateishi, Mohamed Abdel-Wahab, Nicolo Piazza, Michele Pighi, Rodrigo Modolo, Martijn van MourikJoanna Wykrzykowska, Robbert J de Winter, Pedro A Lemos, Fábio S de Brito, Hideyuki Kawashima, Lars Søndergaard, Liesbeth Rosseel, Rutao Wang, Chao Gao, Ling Tao, Andreas Rück, Won-Keun Kim, Niels van Royen, Christian J Terkelsen, Henrik Nissen, Matti Adam, Tanja K Rudolph, Hendrik Wienemann, Ryo Torii, Franz Josef Neuman, Simon Schoechlin, Mao Chen, Ahmed Elkoumy, Hesham Elzomor, Ignacio J Amat-Santos, Darren Mylotte, Osama Soliman, Yoshinobu Onuma

^*Corresponding author for this work

Department of Cardiology

3 Citations (Scopus)

Abstract

Paravalvular leak (PVL) is a shortcoming that can erode the clinical benefits of transcatheter valve replacement (TAVR) and therefore a readily applicable method (aortography) to quantitate PVL objectively and accurately in the interventional suite is appealing to all operators. The ratio between the areas of the time-density curves in the aorta and left ventricular outflow tract (LVOT-AR) defines the regurgitation fraction (RF). This technique has been validated in a mock circulation; a single injection in diastole was further tested in porcine and ovine models. In the clinical setting, LVOT-AR was compared with trans-thoracic and trans-oesophageal echocardiography and cardiac magnetic resonance imaging. LVOT-AR > 17% discriminates mild from moderate aortic regurgitation on echocardiography and confers a poor prognosis in multiple registries, and justifies balloon post-dilatation. The LVOT-AR differentiates the individual performances of many old and novel devices and is being used in ongoing randomized trials and registries.

Original language	English
Article number	1161779
Journal	Frontiers in Cardiovascular Medicine
Volume	10
ISSN	2297-055X
DOIs	https://doi.org/10.3389/fcvm.2023.1161779
Publication status	Published - 2023

Keywords

aortic regurgitation
paravalvular leak
quantitative aortography
transcatheter aortic valve implantation
transcatheter aortic valve replacement
videodensitometry

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10.3389/fcvm.2023.1161779

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Abdelshafy, M., Serruys, P. W., Tsai, T.-Y., Revaiah, P. C., Garg, S., Aben, J.-P., Schultz, C. J., Abdelghani, M., Tonino, P. A. L., Miyazaki, Y., Rutten, M. C. M., Cox, M., Sahyoun, C., Teng, J., Tateishi, H., Abdel-Wahab, M., Piazza, N., Pighi, M., Modolo, R., ... Onuma, Y. (2023). Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement. Frontiers in Cardiovascular Medicine, 10, Article 1161779. https://doi.org/10.3389/fcvm.2023.1161779

Abdelshafy, M, Serruys, PW, Tsai, T-Y, Revaiah, PC, Garg, S, Aben, J-P, Schultz, CJ, Abdelghani, M, Tonino, PAL, Miyazaki, Y, Rutten, MCM, Cox, M, Sahyoun, C, Teng, J, Tateishi, H, Abdel-Wahab, M, Piazza, N, Pighi, M, Modolo, R, van Mourik, M, Wykrzykowska, J, de Winter, RJ, Lemos, PA, de Brito, FS, Kawashima, H, Søndergaard, L, Rosseel, L, Wang, R, Gao, C, Tao, L, Rück, A, Kim, W-K, van Royen, N, Terkelsen, CJ, Nissen, H, Adam, M, Rudolph, TK, Wienemann, H, Torii, R, Josef Neuman, F, Schoechlin, S, Chen, M, Elkoumy, A, Elzomor, H, Amat-Santos, IJ, Mylotte, D, Soliman, O & Onuma, Y 2023, 'Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement', Frontiers in Cardiovascular Medicine, vol. 10, 1161779. https://doi.org/10.3389/fcvm.2023.1161779

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title = "Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement",

abstract = "Paravalvular leak (PVL) is a shortcoming that can erode the clinical benefits of transcatheter valve replacement (TAVR) and therefore a readily applicable method (aortography) to quantitate PVL objectively and accurately in the interventional suite is appealing to all operators. The ratio between the areas of the time-density curves in the aorta and left ventricular outflow tract (LVOT-AR) defines the regurgitation fraction (RF). This technique has been validated in a mock circulation; a single injection in diastole was further tested in porcine and ovine models. In the clinical setting, LVOT-AR was compared with trans-thoracic and trans-oesophageal echocardiography and cardiac magnetic resonance imaging. LVOT-AR > 17\% discriminates mild from moderate aortic regurgitation on echocardiography and confers a poor prognosis in multiple registries, and justifies balloon post-dilatation. The LVOT-AR differentiates the individual performances of many old and novel devices and is being used in ongoing randomized trials and registries.",

keywords = "aortic regurgitation, paravalvular leak, quantitative aortography, transcatheter aortic valve implantation, transcatheter aortic valve replacement, videodensitometry",

author = "Mahmoud Abdelshafy and Serruys, \{Patrick W\} and Tsung-Ying Tsai and Revaiah, \{Pruthvi Chenniganahosahalli\} and Scot Garg and Jean-Paul Aben and Schultz, \{Carl J\} and Mohammad Abdelghani and Tonino, \{Pim A L\} and Yosuke Miyazaki and Rutten, \{Marcel C M\} and Martijn Cox and Cherif Sahyoun and Justin Teng and Hiroki Tateishi and Mohamed Abdel-Wahab and Nicolo Piazza and Michele Pighi and Rodrigo Modolo and \{van Mourik\}, Martijn and Joanna Wykrzykowska and \{de Winter\}, \{Robbert J\} and Lemos, \{Pedro A\} and \{de Brito\}, \{F{\'a}bio S\} and Hideyuki Kawashima and Lars S{\o}ndergaard and Liesbeth Rosseel and Rutao Wang and Chao Gao and Ling Tao and Andreas R{\"u}ck and Won-Keun Kim and \{van Royen\}, Niels and Terkelsen, \{Christian J\} and Henrik Nissen and Matti Adam and Rudolph, \{Tanja K\} and Hendrik Wienemann and Ryo Torii and \{Josef Neuman\}, Franz and Simon Schoechlin and Mao Chen and Ahmed Elkoumy and Hesham Elzomor and Amat-Santos, \{Ignacio J\} and Darren Mylotte and Osama Soliman and Yoshinobu Onuma",

note = "{\textcopyright} 2023 Abdelshafy, Serruys, Tsai, Revaiah, Grag, Aben, Schultz, Abdelghani, Tonino, Miyazaki, Rutten, Cox, Sahyoun, Teng, Tateishi, Abdel-Wahab, Piazza, Pighi, Modolo, van Mourik, Wykrzykowska, de Wintet, Lemos, de Brito, Kawashima, S{\o}endergaard, Rosseel, Wang, Gao, Tao, R{\"u}ck, Kim, van Royen, Terkelsen, Nissen, Adam, Rudolph, Wienemann, Torii, Neuman, Schoechlin, Chen, Elkoumy, Elzomor, Amat-Santos, Mylotte, Soliman and Onuma.",

year = "2023",

doi = "10.3389/fcvm.2023.1161779",

language = "English",

volume = "10",

journal = "Frontiers in Cardiovascular Medicine",

issn = "2297-055X",

publisher = "Frontiers Media S.A.",

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TY - JOUR

T1 - Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement

AU - Abdelshafy, Mahmoud

AU - Serruys, Patrick W

AU - Tsai, Tsung-Ying

AU - Revaiah, Pruthvi Chenniganahosahalli

AU - Garg, Scot

AU - Aben, Jean-Paul

AU - Schultz, Carl J

AU - Abdelghani, Mohammad

AU - Tonino, Pim A L

AU - Miyazaki, Yosuke

AU - Rutten, Marcel C M

AU - Cox, Martijn

AU - Sahyoun, Cherif

AU - Teng, Justin

AU - Tateishi, Hiroki

AU - Abdel-Wahab, Mohamed

AU - Piazza, Nicolo

AU - Pighi, Michele

AU - Modolo, Rodrigo

AU - van Mourik, Martijn

AU - Wykrzykowska, Joanna

AU - de Winter, Robbert J

AU - Lemos, Pedro A

AU - de Brito, Fábio S

AU - Kawashima, Hideyuki

AU - Søndergaard, Lars

AU - Rosseel, Liesbeth

AU - Wang, Rutao

AU - Gao, Chao

AU - Tao, Ling

AU - Rück, Andreas

AU - Kim, Won-Keun

AU - van Royen, Niels

AU - Terkelsen, Christian J

AU - Nissen, Henrik

AU - Adam, Matti

AU - Rudolph, Tanja K

AU - Wienemann, Hendrik

AU - Torii, Ryo

AU - Josef Neuman, Franz

AU - Schoechlin, Simon

AU - Chen, Mao

AU - Elkoumy, Ahmed

AU - Elzomor, Hesham

AU - Amat-Santos, Ignacio J

AU - Mylotte, Darren

AU - Soliman, Osama

AU - Onuma, Yoshinobu

N1 - © 2023 Abdelshafy, Serruys, Tsai, Revaiah, Grag, Aben, Schultz, Abdelghani, Tonino, Miyazaki, Rutten, Cox, Sahyoun, Teng, Tateishi, Abdel-Wahab, Piazza, Pighi, Modolo, van Mourik, Wykrzykowska, de Wintet, Lemos, de Brito, Kawashima, Søendergaard, Rosseel, Wang, Gao, Tao, Rück, Kim, van Royen, Terkelsen, Nissen, Adam, Rudolph, Wienemann, Torii, Neuman, Schoechlin, Chen, Elkoumy, Elzomor, Amat-Santos, Mylotte, Soliman and Onuma.

PY - 2023

Y1 - 2023

N2 - Paravalvular leak (PVL) is a shortcoming that can erode the clinical benefits of transcatheter valve replacement (TAVR) and therefore a readily applicable method (aortography) to quantitate PVL objectively and accurately in the interventional suite is appealing to all operators. The ratio between the areas of the time-density curves in the aorta and left ventricular outflow tract (LVOT-AR) defines the regurgitation fraction (RF). This technique has been validated in a mock circulation; a single injection in diastole was further tested in porcine and ovine models. In the clinical setting, LVOT-AR was compared with trans-thoracic and trans-oesophageal echocardiography and cardiac magnetic resonance imaging. LVOT-AR > 17% discriminates mild from moderate aortic regurgitation on echocardiography and confers a poor prognosis in multiple registries, and justifies balloon post-dilatation. The LVOT-AR differentiates the individual performances of many old and novel devices and is being used in ongoing randomized trials and registries.

AB - Paravalvular leak (PVL) is a shortcoming that can erode the clinical benefits of transcatheter valve replacement (TAVR) and therefore a readily applicable method (aortography) to quantitate PVL objectively and accurately in the interventional suite is appealing to all operators. The ratio between the areas of the time-density curves in the aorta and left ventricular outflow tract (LVOT-AR) defines the regurgitation fraction (RF). This technique has been validated in a mock circulation; a single injection in diastole was further tested in porcine and ovine models. In the clinical setting, LVOT-AR was compared with trans-thoracic and trans-oesophageal echocardiography and cardiac magnetic resonance imaging. LVOT-AR > 17% discriminates mild from moderate aortic regurgitation on echocardiography and confers a poor prognosis in multiple registries, and justifies balloon post-dilatation. The LVOT-AR differentiates the individual performances of many old and novel devices and is being used in ongoing randomized trials and registries.

KW - aortic regurgitation

KW - paravalvular leak

KW - quantitative aortography

KW - transcatheter aortic valve implantation

KW - transcatheter aortic valve replacement

KW - videodensitometry

UR - https://www.scopus.com/pages/publications/85166427979

U2 - 10.3389/fcvm.2023.1161779

DO - 10.3389/fcvm.2023.1161779

M3 - Review

C2 - 37529710

SN - 2297-055X

VL - 10

JO - Frontiers in Cardiovascular Medicine

JF - Frontiers in Cardiovascular Medicine

M1 - 1161779

ER -

Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement

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Keywords

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