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Usefulness of TEE as the Primary Imaging Technique to Guide Transcatheter Transapical Aortic Valve Implantation

التفاصيل البيبلوغرافية
العنوان: Usefulness of TEE as the Primary Imaging Technique to Guide Transcatheter Transapical Aortic Valve Implantation
المؤلفون: Mélanie Côté, Sébastien Bergeron, Josep Rodés-Cabau, Philippe Pibarot, Jerôme Lemieux, Rodrigo Bagur, Eric Dumont, Jacques Villeneuve, Robert De Larochellière, Daniel Doyle, Olivier F. Bertrand
المصدر: JACC: Cardiovascular Imaging. 4:115-124
بيانات النشر: Elsevier BV, 2011.
سنة النشر: 2011
مصطلحات موضوعية: Male, Aortic valve, Cardiac Catheterization, Time Factors, medicine.medical_treatment, Radiography, Contrast Media, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Radiography, Interventional, Severity of Illness Index, 0302 clinical medicine, Risk Factors, 030212 general & internal medicine, Cardiac catheterization, Aged, 80 and over, Heart Valve Prosthesis Implantation, medicine.diagnostic_test, Quebec, 3. Good health, Treatment Outcome, medicine.anatomical_structure, Radiology Nuclear Medicine and imaging, Heart Valve Prosthesis, Aortic valve stenosis, Female, transapical, Radiology, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Prosthesis Design, Risk Assessment, 03 medical and health sciences, Severity of illness, medicine, Humans, Radiology, Nuclear Medicine and imaging, Ultrasonography, Interventional, transcatheter aortic valve implantation, Aged, Mitral regurgitation, Chi-Square Distribution, transesophageal echocardiography, business.industry, aortic stenosis, Aortic Valve Stenosis, medicine.disease, Logistic Models, Angiography, Feasibility Studies, business, human activities, Chi-squared distribution, Echocardiography, Transesophageal
الوصف: ObjectivesThe aim of this study was to: 1) determine the usefulness of transesophageal echocardiography (TEE) as the primary technique to guide transapical (TA) transcatheter aortic valve implantation (TAVI); and 2) to compare TEE with angiography as the primary imaging modality for TA-TAVI guidance.BackgroundTEE has been routinely used as an adjunct to angiography during TA-TAVI procedures, but very few data exist on the use of TEE as the primary imaging technique guiding TA-TAVI.MethodsOne hundred consecutive high-risk patients (mean age 79 ± 9 years, mean logistic EuroSCORE: 25.8 ± 17.6%) who underwent TA-TAVI in our center were included. The Edwards valve was used in all cases, and all procedures were performed in an operating room without hybrid facilities. The TA-TAVI was primarily guided by angiography in the first 25 patients (A-TAVI group) and by TEE in the last 75 patients (TEE-TAVI group). Procedural, 30-day, and follow-up results were evaluated.ResultsNo differences were observed between groups at baseline except for a higher (p = 0.001) prevalence of moderate or severe mitral regurgitation in the TEE-TAVI group. The procedure was successful in 97.3% and 100% of the patients in the TEE-TAVI and A-TAVI groups, respectively (p = 1.0), and a lower contrast volume was used in the TEE-TAVI group (12 [5 to 20] ml vs. 40 [20 to 50] ml, p < 0.0001). There were no differences between groups in the occurrence of valve malposition needing a second valve (TEE-TAVI: 5.3%; A-TAVI: 4%; p = 1.0) or valve embolization (TEE-TAVI: 1.3%; A-TAVI: 4%; p = 0.44). The results regarding post-procedural valve hemodynamic status and aortic regurgitation were similar between groups. The survival rates at 30-day and 1-year follow-up were 87% and 75% in the TEE-group and 88% and 84% in the A-TAVI group, respectively (log-rank = 0.49).ConclusionsTEE-TAVI was associated with similar acute and midterm results as A-TAVI and significantly reduced contrast media use during the procedures. These results suggest the feasibility and safety of performing TA-TAVI procedures in an operating room without hybrid facilities, but larger studies are needed to confirm these findings.
تدمد: 1936-878X
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9de8a10c37c93c7d5e1ecf0b9d60e42a
https://doi.org/10.1016/j.jcmg.2010.10.009
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....9de8a10c37c93c7d5e1ecf0b9d60e42a
قاعدة البيانات: OpenAIRE
الوصف
تدمد:1936878X