Author + information
- Gareth Crouch,
- Jayme Bennetts,
- Ajay Sinhal,
- Amy Penhall,
- Craig Bradbrook,
- Carmine De Pasquale,
- Rob Baker and
- Joseph Selvanayagam
Transcatheter aortic valve implantation (TAVI) is associated with a significant incidence of paravalvular leak. Cardiovascular magnetic resonance (CMR) directly quantifies aortic regurgitation (AR) with accuracy and reproducibility using phase-contrast velocity mapping. We compare CMR and echocardiographic analysis of AR in patients undergoing TAVI and open aortic valve replacement (AVR).
38 patients (20 male) with confirmed severe aortic stenosis undergoing either TAVI (20 patients) or high-risk open AVR. CMR and TTE were carried out pre-operatively and within two weeks post-operatively. CMR protocol consisted of standard views and forward and regurgitant aortic flows using through-plane phase-contrast velocity mapping. AR severity by CMR was defined as regurgitation fraction of mild ≤15%, moderate 16[[Unable to Display Character: –]]25%, moderate-severe 26[[Unable to Display Character: –]]48%, and severe >48%.
EuroSCORE's were similar between groups. Mean preoperative ventricular function was similar in the groups. Post-procedure regurgitant fraction using CMR was higher in the transcatheter group when compared to the open AVR group (17.7 vs. 4.8% p<0.01). Using published criteria for comparing CMR and qualitative echo, AR was estimated at significantly lower values by echo than CMR (p<0.01).
Compared to CMR based quantitative analysis, TTE consistently underestimated the degree of paravalvular AR, likely due to image degradation associated with the implanted valve and/or poor echocardiographic windows.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: MRI IV CMR in Valve Disease and Imaging Intracardiac and Vascular Flows
Abstract Category: 19. Imaging: MRI
Presentation Number: 1224-318
- 2013 American College of Cardiology Foundation