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. 2015:2015:802840.
doi: 10.1155/2015/802840. Epub 2015 Sep 7.

Calcification Characteristics of Low-Flow Low-Gradient Severe Aortic Stenosis in Patients Undergoing Transcatheter Aortic Valve Replacement

Barbara E Stähli  1 , Thi Dan Linh Nguyen-Kim  2 , Cathérine Gebhard  1 , Thomas Frauenfelder  2 , Felix C Tanner  1 , Fabian Nietlispach  1 , Francesco Maisano  3 , Volkmar Falk  3 , Thomas F Lüscher  1 , Willibald Maier  1 , Ronald K Binder  1
Affiliations

Calcification Characteristics of Low-Flow Low-Gradient Severe Aortic Stenosis in Patients Undergoing Transcatheter Aortic Valve Replacement

Barbara E Stähli et al. Cardiol Res Pract. 2015.

Abstract

Low-flow low-gradient severe aortic stenosis (LFLGAS) is associated with worse outcomes. Aortic valve calcification patterns of LFLGAS as compared to non-LFLGAS have not yet been thoroughly assessed. 137 patients undergoing transcatheter aortic valve replacement (TAVR) with preprocedural multidetector computed tomography (MDCT) and postprocedural transthoracic echocardiography were enrolled. Calcification characteristics were assessed by MDCT both for the total aortic valve and separately for each leaflet. 34 patients had LFLGAS and 103 non-LFLGAS. Total aortic valve calcification volume (p < 0.001), mass (p < 0.001), and density (p = 0.004) were lower in LFLGAS as compared to non-LFLGAS patients. At 30-day follow-up, mean transaortic pressure gradients and more than mild paravalvular regurgitation did not differ between groups. In conclusion, LFLGAS and non-LFLGAS express different calcification patterns which, however, did not impact on device success after TAVR.

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Figures

Figure 1
Figure 1
Multidetector computed tomography (MDCT) analysis illustrating calcification measurements. (a) Centerline of the aortic root and the ascending aorta. (b), (c), and (d) Anchor points at the level of the insertion of the aortic leaflets. (e) Measurement of calcification volume and mass.
Figure 2
Figure 2
Postprocedural paravalvular aortic regurgitation in patients with low-flow low-gradient severe aortic stenosis (LFLGAS) and those with non-LFLGAS. (a) LFLGAS patients. (b) Non-LFLGAS patients.
Figure 3
Figure 3
Postprocedural symptomatic improvement in patients with low-flow low-gradient severe aortic stenosis (LFLGAS) and those with non-LFLGAS. (a) LFLGAS patients. (b) Non-LFLGAS patients. NYHA indicates New York Heart Association functional class. p ≤ 0.05 denotes a significant difference between patients with low-flow low-gradient severe aortic stenosis (LFLGAS) and those with non-LFLGAS.
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