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Hao Wang
Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7925-7153
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Background: The aim was to compare two echocardiographic methods for prosthetic valve effective orifice area (EOA) measurement following transcatheter self-expanding aortic valve implantation.
Methods: EOA was calculated according to the continuity equation. Two methods were constructed. In Method #1, the left ventricular outflow tract diameter (LVOTd 1 ) was measured at the entry of the prosthesis (from trailing to leading edge); in Method #2, the LVOTd 2 was measured proximal to the prosthetic valve leaflets (from trailing to leading edge). VTI LVOT was recorded by pulse doppler (PW) from apical windows. The region of the PW sampling should match that of the LVOTd measurement with precise localization.
Results: A total of 113 consecutive patients were included in the study. All patients were followed up at one year. The mean transvalvular pressure gradient correlated better with the indexed EOA 1 (EOAI 1 ) (r=-0.701, p<0.0001) than EOAI 2 (r=-0.645, p<0.0001). Intra-observer reliability of EOA 1 and was EOA 2 was excellent (ICCs ranging from: EOA 1 : 0.923 to 0.984, and EOA 2 : 0.898 to 0.979, respectively). Interobserver reliability of EOA 1 and was EOA 2 was good (ICCs ranging from: EOA 1 : 0.742 to 0.948, and EOA 2 : 0.589 to 0.901, respectively).
Conclusions: For transcatheter self-expanding valve EOA measurement, LVOTd should be measured in the entry of the prosthesis stent (from trailing to leading edge), and VTI LVOT should be measured when the PW sample is located in the entry of the prosthesis stent.
Keywords
Aortic valve stenosis, Transcatheter aortic valve replacement, Self-expanding valve, 2D Doppler echocardiography, Continuity equation
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Hao Wang
Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7925-7153
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 22 Jan, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The aim was to compare two echocardiographic methods for prosthetic valve effective orifice area (EOA) measurement following transcatheter self-expanding aortic valve implantation.
Methods: EOA was calculated according to the continuity equation. Two methods were constructed. In Method #1, the left ventricular outflow tract diameter (LVOTd 1 ) was measured at the entry of the prosthesis (from trailing to leading edge); in Method #2, the LVOTd 2 was measured proximal to the prosthetic valve leaflets (from trailing to leading edge). VTI LVOT was recorded by pulse doppler (PW) from apical windows. The region of the PW sampling should match that of the LVOTd measurement with precise localization.
Results: A total of 113 consecutive patients were included in the study. All patients were followed up at one year. The mean transvalvular pressure gradient correlated better with the indexed EOA 1 (EOAI 1 ) (r=-0.701, p<0.0001) than EOAI 2 (r=-0.645, p<0.0001). Intra-observer reliability of EOA 1 and was EOA 2 was excellent (ICCs ranging from: EOA 1 : 0.923 to 0.984, and EOA 2 : 0.898 to 0.979, respectively). Interobserver reliability of EOA 1 and was EOA 2 was good (ICCs ranging from: EOA 1 : 0.742 to 0.948, and EOA 2 : 0.589 to 0.901, respectively).
Conclusions: For transcatheter self-expanding valve EOA measurement, LVOTd should be measured in the entry of the prosthesis stent (from trailing to leading edge), and VTI LVOT should be measured when the PW sample is located in the entry of the prosthesis stent.
Figure 1
Figure 2
Figure 3
Figure 4
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