Ex vivo pilot study of cardiac magnetic resonance velocity mapping for quantification of aortic regurgitation in a porcine model in the presence of a transcatheter heart valve

Nynke H.M. Kooistra, Freek Nijhoff, Masieh Abawi, Pierfrancesco Agostoni, Daniël M. Araya Roos, Sjoerd van Tuijl, Niels Blanken, Michiel Voskuil, Pieter A.F.M. Doevendans, Pieter R. Stella (Corresponding author), Tim Leiner

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Abstract

Accuracy of aortic regurgitation (AR) quantification by magnetic resonance (MR) imaging in the presence of a transcatheter heart valve (THV) remains to be established. We evaluated the accuracy of cardiac MR velocity mapping for quantification of antegrade flow (AF) and retrograde flow (RF) across a THV and the optimal slice position to use in cardiac MR imaging. In a systematic and fully controlled laboratory ex vivo setting, two THVs (Edwards SAPIEN XT, Medtronic CoreValve) were tested in a porcine model (n = 1) under steady flow conditions. Results showed a high level of accuracy and precision. For both THVs, AF was best measured at left ventricular outflow tract level, and RF at ascending aorta level. At these levels, MR had an excellent repeatability (ICC > 0.99), with a tendency to overestimate (4.6 ± 2.4% to 9.4 ± 7.0%). Quantification of AR by MR velocity mapping in the presence of a THV was accurate, precise, and repeatable in this pilot study, when corrected for the systematic error and when the best MR slice position was used. Confirmation of these results in future clinical studies would be a step forward in increasing the accuracy of the assessment of paravalvular AR severity.

Original languageEnglish
Pages (from-to)310-320
Number of pages11
JournalJournal of Cardiovascular Translational Research
Volume12
Issue number4
DOIs
Publication statusPublished - 15 Aug 2019

Keywords

  • Cardiac magnetic resonance velocity mapping
  • Paravalvular aortic regurgitation
  • Quantification
  • Transcatheter heart valve

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