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The following is a summary of “Computed tomography derived predictors of left ventricular obstruction after TAVR,” published in the January 2025 issue of Cardiology by Ferri et al.
Researchers conducted a retrospective study to examine the anatomical characteristics of patients at risk for left ventricular obstruction (LVO) following transcatheter aortic valve replacement (TAVR) using computational tomography (CT).
They analyzed data from 349 individuals undergoing TAVR at San Raffaele Hospital, Milan, Italy, from January 2020 to December 2021. All patients with aortic valve stenosis and available pre-procedural CT data were included, while those with prior heart valve surgery or interventions were excluded.
The results showed 57 patients (16.3%) developed LVO post-procedurally. These individuals were older (83.2 vs 81.4 years, P =0.04), predominantly female (67% vs 47%, P <0.05), and had smaller body surface areas and weights, CT analysis revealed a smaller aorto-mitral angle (107 ° 114° , P <0.001), shorter interventricular septum to leaflet coaptation distance (SLCL 22.1 mm vs 28.1 mm, P <0.001), smaller telo-systolic left ventricular areas (267 mm2 vs 714 mm2), and smaller LVOT areas (404 mm2 vs. 470 mm2, P <0.001) in those with LVO. Multivariate regression identified the telo-systolic LV area (OR 0.998; 95% CI 0.996–0.999; P =0.001) and interventricular septum-to-leaflet coaptation distance (OR 0.92; 95% CI 0.86–0.99; P =0.02) as predictors for LVO occurrence.
Investigators concluded that pre-procedural CT imaging predictors LVO following TAVR were identified, and further multicenter studies with systematic follow-up were needed to confirm these findings.
Source: internationaljournalofcardiology.com/article/S0167-5273(24)01578-X/abstract