Author + information
- Itsik Ben–Dor,
- Rahul Malik,
- Sa'ar Minha,
- Israel Barbash,
- Danny Dvir,
- Steven Goldstein,
- Zuyue Wang,
- Petros Okubagzi,
- Rebecca Torguson,
- Joseph Lindsay,
- Lowell Satler,
- Augusto Pichard and
- Ron Waksman
Patients with severe aortic stenosis and nonobstructed coronary arteries are reported to have reduced coronary flow. Doppler evaluation of proximal coronary flow is feasible using transesophageal echocardiography (TEE). The present study aimed to assess the change in coronary flow in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).
The left main coronary artery was visualized using TEE in 91 patients undergoing TAVR. The peak systolic and diastolic velocities of the coronary flow and the time–velocity integral were obtained before and after TAVR using pulsed wave Doppler.
The mean age was 85.4±4.8 years. Mean aortic gradients decreased from 48.1±16.4 before to 3.6±276 mmHg after, p <0.001. The AVA increased from 0.57±0.16 to 1.9±0.2 cm2, p <0.001. Cardiac output increased from 3.38±1.1 to 3.72±1.0 l/min, p=0.005. The aortic systolic pressure increased from 120.4±21.1 to 136.0±28.1 mmHg, p=0.01. LVEDP decreased significantly 20.8±4.9 to 17.3±3.9 mmHg, p=0.02 after TAVR. The peak systolic velocity, peak diastolic velocity, total velocity time integral, and systolic velocity time integral and diastolic time velocity integral increased significantly after TAVR. (Table)
TAVR resulted in a significant increase in coronary flow as measured by peak systolic velocity, diastolic velocity, and velocity time integral using pulsed wave Doppler by TEE.
West, Room 2004
Sunday, March 10, 2013, 8:30 a.m.–8:35 a.m.
Session Title: Intravascular Imaging and Physiologic Assessment
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2907–5
- 2013 American College of Cardiology Foundation