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Medium‐term CT evaluation of stent geometry, integrity, and valve function of the Edwards SAPIEN transcatheter heart valve in the pulmonary position
Author(s) -
Muller Brieann,
Ghawi Hani,
Heitschmidt Mary G.,
Fogg Louis,
Hibbeln John,
Hijazi Ziyad M.,
Kenny Damien
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26074
Subject(s) - medicine , heart valve , stent , ventricular outflow tract , valve replacement , cardiology , pulmonary valve , prosthesis , multidetector computed tomography , nuclear medicine , computed tomography , stenosis , surgery
Objective Distortion of transcatheter heart valve (THV) stent shape and morphology has been shown to impact on THV function. This study sought to evaluate the relationship between geometrical CT follow‐up data and consequent valve function in patients undergoing transcatheter pulmonary valve replacement with the Edwards SAPIEN THV. Methods All patients were enrolled in the COMPASSION trial. Multidetector computed tomography (MDCT) was performed as part of the study protocol at 6 months and yearly thereafter following valve implantation. Prosthesis eccentricity indices, circularity ratios, and expansion ratios (ER) were calculated. Valve function and reintervention rates were correlated with MDCT findings. Results Twenty consecutive patients undergoing 58 CT scans were included. Maximum Doppler gradients across the right ventricular outflow tract (RVOT) were significantly reduced following valve implantation ( P < 0.001). Geometrical indices and maximum RVOT gradients were compared between the reintervention group ( n = 4) and the nonreintervention group ( n = 16). Although there was no difference in eccentricity index between the groups, ER [6 months: 90 +/− 12% vs. 69 ± 9%; P = 0.014; at 12 months: 89 ± 14 vs. 69 ± 10%; P = 0.018; at 24 months: 87 ± 14% vs. 70 ± 11%; P = 0.056] and valve area [6 months: 3.98 ± 0.54 vs. 2.86 ± 0.38 P = 0.005; at 12 months: 3.93 ± 0.56 vs. 2.86 ± 0.39 P = 0.006; 24 months: 3.78 ± 0.50 vs. 2.90 ± 0.45 P = 0.019] were lower in the reintervention group compared with the nonreintervention group at all time periods. Conclusion Geometrical THV measurements as assessed by CT may predict the need for reintervention in patients undergoing transcatheter pulmonary valve replacement with the SAPIEN valve. Valve symmetry is maintained, however under‐expansion and smaller valve area are strongly associated with the need for reintervention. © 2015 Wiley Periodicals, Inc.