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Type: Artigo
Title: Feasibility study of a synchronized diastolic injection with low contrast volume for proper quantitative assessment of aortic regurgitation in porcine models
Author: Modolo, Rodrigo
Miyazaki, Yosuke
Chang, Chun Chin
Hekkert, Maaike te Lintel
van Sloun, Math
Suchecki, Todd
Aben, Jean-Paul
Soliman, Osama I.
Onuma, Yoshinobu
Duncker, Dirk J.
van Mieghem, Nicolas M.
Serruys, Patrick W.
Abstract: ObjectivesTo evaluate the in vivo feasibility of aortography with one accurately timed diastolic low-volume contrast injection for quantitative assessment of aortic regurgitation (AR) post transcatheter aortic valve replacement (TAVR). BackgroundWith the rise of a minimalistic approach for TAVR, aortography (re)emerges as a pragmatic tool for AR assessment. In a mock circulation system, we have validated the accuracy of a single diastolic injection triggered by electrocardiogram (ECG) with low-contrast volume. MethodsTwo-phase experiment: first, a series of aortograms were performed in a porcine model, with 8 mL of contrast using the synchronized (SYNC) and the conventional non-synchronized (NS) injections. In a second phase, we developed a model of AR by inserting partially unsheathed Wallstents of 6-10 mm of diameter across the pig's aortic valve, performing SYNC injections with 8 mL of contrast and NS injections with 8 mL and 15mL (rate: 20mL/sec). Respective accuracies of SYNC vs. NS were assessed using Passing-Bablock regression. An angiography core laboratory performed quantitative AR assessment with videodensitometry (VD-AR). ResultsThe SYNC injections produced higher opacification of the aortic root compared with NS injections (P=0.04 for density). In the second phase, a regression line for predicting VD-AR based on the SYNC injection resulted in a lower intercept and a slope closer to the line of identity (y=11.9+0.79x, P<0.001, r(2)=0.94) with the NS-8 mL than with the NS-15mL injection (y=26.5+0.55x, P<0.001, r(2)=0.81). ConclusionSynchronized diastolic injection with low contrast volume produced denser images in the aortic root and more accurate than the conventional injection; thus, may be an appealing alternative for assessment of AR post TAVR
Subject: Insuficiência aórtica
Country: Estados Unidos
Editor: Wiley-Liss
Rights: Fechado
Identifier DOI: 10.1002/ccd.27972
Date Issue: 2019
Appears in Collections:FCM - Artigos e Outros Documentos

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