Multidetector CT characteristics of bicuspid aortic valve before transcatheter aortic valve replacement in single center_West China Medical Journal

Authors：

ZHU Jiajun , ZHAO Qian ,  YANG Yining

Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P. R. China;

Corresponding author：

YANG Yining, Email: yangyn5126@163.com

Keywords：

Transcatheter aortic valve replacement; Bicuspid aortic valve; Tricuspid aortic valve; Multidetector computed tomography

DOI：

10.7507/1002-0179.202008059

Video：

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Objective To explore the preoperative evaluation result of multidetector computed tomography (MDCT) in aortic stenosis (AS) patients with bicuspid aortic valve (BAV) undergoing transcatheter aortic valve replacement (TAVR) in order to summarize relevant experience.Methods A total of 33 consecutive AS patients who underwent TAVR in Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University from March 2016 to June 2020 were enrolled, and the preoperative evaluation characteristics of MDCT were compared between tricuspid aortic valve (TAV) and BAV.Results In the 33 patients, whose mean age was (74±6) years, 22 were male and 11 were female, 17 were with BAV and 16 were with TAV. The medium (lower quartile, upper quartile) of calcification score was 360 (192, 1 034) mm³. There were 12 cases of artificial valve model to be speculated Downsize, including 9 calcific BAV cases (75%).Conclusion The calcific BAV has a higher ratio of Downsize in the TAVR procedure.

Citation： ZHU Jiajun, ZHAO Qian, YANG Yining. Multidetector CT characteristics of bicuspid aortic valve before transcatheter aortic valve replacement in single center. West China Medical Journal, 2020, 35(9): 1050-1054. doi: 10.7507/1002-0179.202008059 Copy

1.	Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study. Lancet, 2006, 368(9540): 1005-1011.
2.	Carabello BA, Paulus WJ. Aortic stenosis. Lancet, 2009, 373(9667): 956-966.
3.	Gooley R, Antonis P, Meredith IT. The next era of transcatheter aortic valve replacement: a case illustrating the benefit of a fully re-positionable, re-sheathable, and retrievable prosthesis. Catheter Cardiovasc Interv, 2014, 83(5): 831-835.
4.	Fanning JP, Platts DG, Walters DL, et al. Transcatheter aortic valve implantation (TAVI): valve design and evolution. Int J Cardiol, 2013, 168(3): 1822-1831.
5.	Siu SC, Silversides CK. Bicuspid aortic valve disease. J Am Coll Cardiol, 2010, 55(25): 2789-2800.
6.	Blanke P, Weir-Mccall JR, Achenbach S, et al. Computed tomography imaging in the context of transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR): an expert consensus document of the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr, 2019, 13(1): 1-20.
7.	Binder RK, Webb JG, Willson AB, et al. The impact of integration of a multidetector computed tomography annulus area sizing algorithm on outcomes of transcatheter aortic valve replacement: a prospective, multicenter, controlled trial. J Am Coll Cardiol, 2013, 62(5): 431-438.
8.	Achenbach S, Delgado V, Hausleiter J, et al. SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). J Cardiovasc Comput Tomogr, 2012, 6(6): 366-380.
9.	Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. J Thorac Cardiovasc Surg, 2007, 133(5): 1226-1233.
10.	Jilaihawi H, Wu Y, Yang Y, et al. Morphological characteristics of severe aortic stenosis in China: imaging corelab observations from the first Chinese transcatheter aortic valve trial. Catheter Cardiovasc Interv, 2015, 85(Suppl 1): 752-761.
11.	Leon MB, Smith CR, Mack MJ, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med, 2016, 374(17): 1609-1620.
12.	Hahn RT, Roman MJ, Mogtader AH, et al. Association of aortic dilation with regurgitant, stenotic and functionally normal bicuspid aortic valves. J Am Coll Cardiol, 1992, 19(2): 283-288.
13.	Nkomo VT, Enriquez-Sarano M, Ammash NM, et al. Bicuspid aortic valve associated with aortic dilatation: a community-based study. Arterioscler Thromb Vasc Biol, 2003, 23(2): 351-356.
14.	Keane MG, Wiegers SE, Plappert T, et al. Bicuspid aortic valves are associated with aortic dilatation out of proportion to coexistent valvular lesions. Circulation, 2000, 102(19 Suppl 3): Ⅲ35-Ⅲ39.
15.	中国医师协会心血管内科医师分会结构性心脏病专业委员会. 经导管主动脉瓣置换术中国专家共识(2020更新版). 中国介入心脏病学杂志, 2020, 28(6): 301-309.
16.	Popma JJ, Ramadan R. CT Imaging of bicuspid aortic valve disease for TAVR. JACC Cardiovasc Imaging, 2016, 9(10): 1159-1163.
17.	Frangieh AH, Kasel AM. TAVI in bicuspid aortic valves “made easy”. Eur Heart J, 2017, 38(16): 1177-1181.
18.	Piazza N, De Jaegere P, Schultz C, et al. Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circ Cardiovasc Interv, 2008, 1(1): 74-81.
19.	Ribeiro HB, Sarmento-Leite R, Siqueira D, et al. Coronary obstruction following transcatheter aortic valve implantation. Arq Bras Cardiol, 2014, 102(1): 93-96.
20.	Al Emam AR, Chamsi-Pasha M, Pavlides G. Ostial coronary occlusion during TAVR in bicuspid aortic valve, should we redefine what is a safe ostial height?. Int J Cardiol, 2016, 212: 288-289.
21.	Yousef A, Simard T, Webb J, et al. Transcatheter aortic valve implantation in patients with bicuspid aortic valve: a patient level multi-center analysis. Int J Cardiol, 2015, 189: 282-288.
22.	Fetahovic T, Hayman S, Cox S, et al. The prophylactic chimney snorkel technique for the prevention of acute coronary occlusion in high risk for coronary obstruction transcatheter aortic valve replacement/implantation cases. Heart Lung Circ, 2019, 28(10): e126-e130.
23.	Liao YB, Li YJ, Xiong TY, et al. Comparison of procedural, clinical and valve performance results of transcatheter aortic valve replacement in patients with bicuspid versus tricuspid aortic stenosis. Int J Cardiol, 2018, 254: 69-74.
24.	Patsalis PC, Al-Rashid F, Neumann T, et al. Preparatory balloon aortic valvuloplasty during transcatheter aortic valve implantation for improved valve sizing. JACC Cardiovasc Interv, 2013, 6(9): 965-971.
25.	Philip F, Faza NN, Schoenhagen P, et al. Aortic annulus and root characteristics in severe aortic stenosis due to bicuspid aortic valve and tricuspid aortic valves: implications for transcatheter aortic valve therapies. Catheter Cardiovasc Interv, 2015, 86(2): E88-E98.
26.	Das R, Puri R. Transcatheter treatment of bicuspid aortic valve disease: imaging and interventional considerations. Front Cardiovasc Med, 2018, 5: 91.

1. Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study. Lancet, 2006, 368(9540): 1005-1011.
2. Carabello BA, Paulus WJ. Aortic stenosis. Lancet, 2009, 373(9667): 956-966.
3. Gooley R, Antonis P, Meredith IT. The next era of transcatheter aortic valve replacement: a case illustrating the benefit of a fully re-positionable, re-sheathable, and retrievable prosthesis. Catheter Cardiovasc Interv, 2014, 83(5): 831-835.
4. Fanning JP, Platts DG, Walters DL, et al. Transcatheter aortic valve implantation (TAVI): valve design and evolution. Int J Cardiol, 2013, 168(3): 1822-1831.
5. Siu SC, Silversides CK. Bicuspid aortic valve disease. J Am Coll Cardiol, 2010, 55(25): 2789-2800.
6. Blanke P, Weir-Mccall JR, Achenbach S, et al. Computed tomography imaging in the context of transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR): an expert consensus document of the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr, 2019, 13(1): 1-20.
7. Binder RK, Webb JG, Willson AB, et al. The impact of integration of a multidetector computed tomography annulus area sizing algorithm on outcomes of transcatheter aortic valve replacement: a prospective, multicenter, controlled trial. J Am Coll Cardiol, 2013, 62(5): 431-438.
8. Achenbach S, Delgado V, Hausleiter J, et al. SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). J Cardiovasc Comput Tomogr, 2012, 6(6): 366-380.
9. Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. J Thorac Cardiovasc Surg, 2007, 133(5): 1226-1233.
10. Jilaihawi H, Wu Y, Yang Y, et al. Morphological characteristics of severe aortic stenosis in China: imaging corelab observations from the first Chinese transcatheter aortic valve trial. Catheter Cardiovasc Interv, 2015, 85(Suppl 1): 752-761.
11. Leon MB, Smith CR, Mack MJ, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med, 2016, 374(17): 1609-1620.
12. Hahn RT, Roman MJ, Mogtader AH, et al. Association of aortic dilation with regurgitant, stenotic and functionally normal bicuspid aortic valves. J Am Coll Cardiol, 1992, 19(2): 283-288.
13. Nkomo VT, Enriquez-Sarano M, Ammash NM, et al. Bicuspid aortic valve associated with aortic dilatation: a community-based study. Arterioscler Thromb Vasc Biol, 2003, 23(2): 351-356.
14. Keane MG, Wiegers SE, Plappert T, et al. Bicuspid aortic valves are associated with aortic dilatation out of proportion to coexistent valvular lesions. Circulation, 2000, 102(19 Suppl 3): Ⅲ35-Ⅲ39.
15. 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 经导管主动脉瓣置换术中国专家共识(2020更新版). 中国介入心脏病学杂志, 2020, 28(6): 301-309.
16. Popma JJ, Ramadan R. CT Imaging of bicuspid aortic valve disease for TAVR. JACC Cardiovasc Imaging, 2016, 9(10): 1159-1163.
17. Frangieh AH, Kasel AM. TAVI in bicuspid aortic valves “made easy”. Eur Heart J, 2017, 38(16): 1177-1181.
18. Piazza N, De Jaegere P, Schultz C, et al. Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circ Cardiovasc Interv, 2008, 1(1): 74-81.
19. Ribeiro HB, Sarmento-Leite R, Siqueira D, et al. Coronary obstruction following transcatheter aortic valve implantation. Arq Bras Cardiol, 2014, 102(1): 93-96.
20. Al Emam AR, Chamsi-Pasha M, Pavlides G. Ostial coronary occlusion during TAVR in bicuspid aortic valve, should we redefine what is a safe ostial height?. Int J Cardiol, 2016, 212: 288-289.
21. Yousef A, Simard T, Webb J, et al. Transcatheter aortic valve implantation in patients with bicuspid aortic valve: a patient level multi-center analysis. Int J Cardiol, 2015, 189: 282-288.
22. Fetahovic T, Hayman S, Cox S, et al. The prophylactic chimney snorkel technique for the prevention of acute coronary occlusion in high risk for coronary obstruction transcatheter aortic valve replacement/implantation cases. Heart Lung Circ, 2019, 28(10): e126-e130.
23. Liao YB, Li YJ, Xiong TY, et al. Comparison of procedural, clinical and valve performance results of transcatheter aortic valve replacement in patients with bicuspid versus tricuspid aortic stenosis. Int J Cardiol, 2018, 254: 69-74.
24. Patsalis PC, Al-Rashid F, Neumann T, et al. Preparatory balloon aortic valvuloplasty during transcatheter aortic valve implantation for improved valve sizing. JACC Cardiovasc Interv, 2013, 6(9): 965-971.
25. Philip F, Faza NN, Schoenhagen P, et al. Aortic annulus and root characteristics in severe aortic stenosis due to bicuspid aortic valve and tricuspid aortic valves: implications for transcatheter aortic valve therapies. Catheter Cardiovasc Interv, 2015, 86(2): E88-E98.
26. Das R, Puri R. Transcatheter treatment of bicuspid aortic valve disease: imaging and interventional considerations. Front Cardiovasc Med, 2018, 5: 91.

West China Medical Journal

Multidetector CT characteristics of bicuspid aortic valve before transcatheter aortic valve replacement in single center

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