A novel synchronised diastolic injection method to reduce contrast volume during aortography for aortic regurgitation assessment: in vitro experiment of a transcatheter heart valve model

Y. Miyazaki, M. Abdelghani, E.S. de Boer, J.P. Aben, M. van Sloun, T. Suchecki, M. van't Veer, C. Collet, T. Asano, Y. Katagiri, E. Tenekecioglu, O.I.I. Soliman, Y. Onuma, R. de Winter, P. Tonino, F.N. van de Vosse, M.C.M. Rutten, P.W. Serruys

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)

Abstract

Aims: In the minimalist transcatheter aortic valve implantation (TAVI) era, the usage of transoesophageal echocardiography has become restricted. Conversely, aortography has gained clinical ground in quantifying prosthetic valve regurgitation (PVR) during the procedure. In a mock circulation system, we sought to compare the contrast volume required and the accuracy of aortographic videodensitometric PVR assessment using a synchronised diastolic and standard (non-synchronised) injection aortography. Methods and results: Synchronised diastolic injection triggered by the signal stemming from the mock circulation was compared with standard non-synchronised injection. A transcatheter heart valve was implanted and was deformed step by step by advancing a screw perpendicularly to the cage of the valve in order to create increasing PVR. Quantitative measurement of PVR was derived from time-density curves of both a reference area (aortic root) and a region of interest (left ventricle) developed by a videodensitometric software. The volume of contrast required for the synchronised diastolic injection was significantly less than in the non-synchronised injection (8.1 [7.9-8.5] ml vs. 19.4 [19.2-19.9] ml, p<0.001). The correlation between the two methods was substantial (Spearman's coefficient rho ranging from 0.991 to 0.968). Intraobserver intra-class correlation coefficient for both methods of injection was 0.999 (95% CI: 0.996-1.000) for the synchronised diastolic and 0.999 (95% CI: 0.996-1.000) for the non-synchronised injection group. The mean difference in the rating was 0.17% and limits of agreement were ±1.64% for both groups. Conclusions: A short synchronised diastolic injection enables contrast volume reduction during aortography without compromising the accuracy of the quantitative assessment of PVR using videodensitometry.

Original languageEnglish
Pages (from-to)1289-1296
Number of pages8
JournalEuroIntervention
Volume13
Issue number11
DOIs
Publication statusPublished - 20 Dec 2017

Keywords

  • Aortic stenosis
  • Paravalvular leak
  • Transcatheter aortic valve implantation (TAVI)
  • Reproducibility of Results
  • Diastole
  • Models, Cardiovascular
  • Humans
  • Injections
  • Contrast Media/administration & dosage
  • Aortography/methods
  • Aortic Valve/diagnostic imaging
  • Aortic Valve Insufficiency/diagnostic imaging
  • Radiographic Image Interpretation, Computer-Assisted
  • Observer Variation
  • Models, Anatomic

Fingerprint Dive into the research topics of 'A novel synchronised diastolic injection method to reduce contrast volume during aortography for aortic regurgitation assessment: in vitro experiment of a transcatheter heart valve model'. Together they form a unique fingerprint.

Cite this