TY - JOUR
T1 - Computed Tomography Annular Dimensions
T2 - A Novel Method to Compare Prosthetic Valve Hemodynamics
AU - Deeb, G. Michael
AU - Popma, Jeffrey J.
AU - Chetcuti, Stanley J.
AU - Yakubov, Steven J.
AU - Mumtaz, Mubashir
AU - Gleason, Thomas G.
AU - Williams, Mathew R.
AU - Gada, Hemal
AU - Oh, Jae K.
AU - Li, Shuzhen
AU - Boulware, Michael J.
AU - Kappetein, Arie Pieter
AU - Reardon, Michael J.
N1 - Funding Information:
Medtronic (Minneapolis, Minnesota) funded the CoreValve US Pivotal High Risk and SURTAVI trials. Jane Moore, MS, an employee of Medtronic, drafted the Methods, created all tables and figures, and provided a technical review of the manuscript. Dr Popma has received institutional research grants from Medtronic , Boston Scientific and Direct Flow Medical. Dr Chetcuti reports grant support from Medtronic and has received grant support for clinical trials from Abbott and Gore Medical. Dr Yakubov has received institutional research grants from Boston Scientific and Medtronic. Dr Gleason receives institutional grant support from Medtronic and Boston Scientific. Dr Williams has received research grants from Medtronic.
Publisher Copyright:
© 2020 The Society of Thoracic Surgeons
PY - 2020/11
Y1 - 2020/11
N2 - Background: The Cardiac Surgical Societies Valve Labeling Task Force consensus document acknowledged inconsistent sizing and labeling of prosthetic heart valves. This study compared the labeled size, internal diameter, and hemodynamics of different surgical and transcatheter valve types implanted into the same size annulus, measured by preprocedural computed tomography (CT). Methods: Patients were retrospectively sorted into 3 CT annular diameter size groups: small (less than 23 mm), medium (23 to less than 26 mm), and large (26 mm or greater). Surgical valves were sorted into 4 categories based on tissue and design: (stentless porcine, standard stented bovine, wraparound stented bovine, and stented porcine). Comparisons were made within the surgical types and with a transcatheter valve. Echocardiograms were independently assessed and CTs were centrally measured. Results: We analyzed 726 surgical and 923 transcatheter valve paired data sets. Among the various valve types implanted into the same size CT annulus, there were significant differences regarding size, internal diameter, and hemodynamics within all 3 size groups. Root enlargement procedures occurred in 1.2% with no differences across valve types or size groups. Transcatheter valve hemodynamics were similar to stentless valves and were significantly better than all stented valves. There was no difference in hemodynamics between the 2 bovine stented valve types, and stented porcine valves were inferior to all valve types. Conclusions: This study documents that prosthetic heart valve sizing and labeling inconsistencies exist. Use of preoperative CT annular dimensions is the most accurate method to compare size, internal diameter, and hemodynamics of bioprosthetic aortic valves because it compares values among various valve types implanted into the same size annulus.
AB - Background: The Cardiac Surgical Societies Valve Labeling Task Force consensus document acknowledged inconsistent sizing and labeling of prosthetic heart valves. This study compared the labeled size, internal diameter, and hemodynamics of different surgical and transcatheter valve types implanted into the same size annulus, measured by preprocedural computed tomography (CT). Methods: Patients were retrospectively sorted into 3 CT annular diameter size groups: small (less than 23 mm), medium (23 to less than 26 mm), and large (26 mm or greater). Surgical valves were sorted into 4 categories based on tissue and design: (stentless porcine, standard stented bovine, wraparound stented bovine, and stented porcine). Comparisons were made within the surgical types and with a transcatheter valve. Echocardiograms were independently assessed and CTs were centrally measured. Results: We analyzed 726 surgical and 923 transcatheter valve paired data sets. Among the various valve types implanted into the same size CT annulus, there were significant differences regarding size, internal diameter, and hemodynamics within all 3 size groups. Root enlargement procedures occurred in 1.2% with no differences across valve types or size groups. Transcatheter valve hemodynamics were similar to stentless valves and were significantly better than all stented valves. There was no difference in hemodynamics between the 2 bovine stented valve types, and stented porcine valves were inferior to all valve types. Conclusions: This study documents that prosthetic heart valve sizing and labeling inconsistencies exist. Use of preoperative CT annular dimensions is the most accurate method to compare size, internal diameter, and hemodynamics of bioprosthetic aortic valves because it compares values among various valve types implanted into the same size annulus.
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U2 - 10.1016/j.athoracsur.2020.03.012
DO - 10.1016/j.athoracsur.2020.03.012
M3 - Article
C2 - 32289296
AN - SCOPUS:85092756097
VL - 110
SP - 1502
EP - 1510
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 5
ER -