TCT-751 Prevalence and Severity of Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Replacement Defined by Computed Tomography vs. Transthoracic Echocardiography

Fukui, Miho; Tang, Liang; Lesser, John; Niikura, Hiroki; Nunes, Mariana De Oliveira; Burns, Marcus; Schneider, Lynelle; Han, Bo; Garcia, Santiago; Gössl, Mario; Sorajja, Paul; Cavalcante, João L.

doi:10.1016/j.jacc.2019.08.889

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“…Additionally, the assumption of the circular geometry of the LVOT underestimates the true LVOT area by at least 20% and has led to the almost exclusive use of CTA to select BEV and SEV sizes for TAVR. Post‐TAVR LVOT (and hence SVI) measurement by CTA decreases both the incidence and severity of PPM similarly between BEV and SEV 53 . Whether a low SVI by echocardiography is due to LVOT diameter measurement errors, the inherent underestimation of LVOT area by echocardiography, or true low flow state will all lead to a spuriously low IEOA and hence a higher incidence and severity of PPM.…”

Section: Determinants Of Ppm: True Vs Pseudo Ppmmentioning

confidence: 98%

Hemodynamic principles of prosthetic aortic valve evaluation in the transcatheter aortic valve replacement era

et al. 2020

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Evaluating the hemodynamic performance of aortic valve prostheses has relied primarily on echocardiography. This involves calculating the trans-prosthetic valve mean gradient (MG) and aortic valve area (AVA), and assessing for valvular and paravalvular regurgitation in a fashion similar to the native aortic valve. In conjunction with other echocardiographic and nonechocardiographic parameters, MG and AVA are used to distinguish between prosthesis stenosis, prosthesis patient mismatch, pressure recovery, increased flow, and measurement errors. This review will discuss the principles and limitations of echocardiographic evaluation of aortic valve prosthesis following surgical, and transcatheter aortic valve replacement and in comparison to invasive hemodynamics through illustrative clinical cases. K E Y W O R D S Bernoulli equation, continuity equation, echocardiography and catheterization discordance, pressure recovery, prosthesis patient mismatch, transcatheter aortic valve replacement | 739 ABBAS et Al.

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Section: Determinants Of Ppm: True Vs Pseudo Ppmmentioning

confidence: 98%