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Computed tomography anatomical characteristics based on transcatheter aortic valve replacement in aortic regurgitation

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Abstract

This study analyzed computed tomography (CT) measurement characteristics and anatomical classifications based on transcatheter aortic valve replacement (TAVR) in patients with aortic regurgitation (AR) to establish a preliminary summary of CT anatomical characteristics and to design a novel self-expanding transcatheter heart valve (THV). This single-center retrospective cohort study included 136 patients diagnosed with moderate-to-severe AR at Fuwai Hospital from July 2017 to April 2022. Patients were classified into four anatomical classifications according to dual-anchoring multiplanar measurement of where THV anchoring took place. Types 1–3 were considered candidates for TAVR, whereas type 4 was not. Among 136 patients with AR, there were 117 (86.0%) tricuspid, 14 bicuspid, and five quadricuspid valves. Dual-anchoring multiplanar measurement showed that the annulus was smaller than left ventricular outflow tract (LVOT) at 2, 4, 6, 8, and 10 mm on the annulus. The ascending aorta (AA) 40 mm was wider than AA 30 mm and AA 35 mm, but narrower than AA 45 mm and AA 50 mm. For 10% oversize of the THV, the proportions of the annulus, LVOT, and AA unable to meet the diameter were 22.8%, 37.5%, and 50.0%, respectively, and the proportions of anatomical classification types 1–4 were 32.4%, 5.9%, 30.1%, and 31.6%, respectively. The novel THV could significantly improve the type 1 proportion (88.2%). Existing THVs cannot meet the anatomical characteristics of patients with AR. Conversely, based on anatomical characteristics, the novel THV could theoretically facilitate TAVR.

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Data Availability

Data are available on reasonable request. The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

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Funding

This work was supported by the CAMS Innovation Fund for Medical Sciences (CIFMS, grant number: 2021-I2M-C&T-A-010), National Key R&D Program of China (grant number: 2020YFC2008100), and the Capital Health Research and Development of Special Fund Program (Identifiers: NCT05044377, Unique Protocol ID: high-risk AS 2020-08).

Author information

Author notes

  1. Yang Chen and Jie Zhao contributed equally to this work and are co-first authors.

  2. Yong-Jian Wu and Guang-Yuan Song contributed equally to this work and are co-corresponding authors.

Authors and Affiliations

  1. Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing, 100037, China

    Yang Chen, Jie Zhao, Qingrong Liu, Hongliang Zhang, Moyang Wang, Guannan Niu, Dejing Feng, Haiyan Xu & Yongjian Wu

  2. Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing, 100037, China

    Bin Lv

  3. Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China

    Guangyuan Song

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  1. Yang Chen
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Yang Chen, Jie Zhao, Qingrong Liu, Hongliang Zhang, Moyang Wang, and Guannan Niu. Validation, investigation, writing review, and editing were performed by Bin Lv, Haiyan Xu, Guangyuan Song, and Yongjian Wu. The first draft of the manuscript was written by Yang Chen and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Guangyuan Song or Yongjian Wu.

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The authors have no competing interests to declare that are relevant to the content of this article.

Ethics approval

This retrospective cohort study was approved by the institutional ethics committee of Fuwai Hospital.

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All patients provided written informed consent for the collection of CT measurement data.

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Chen, Y., Zhao, J., Liu, Q. et al. Computed tomography anatomical characteristics based on transcatheter aortic valve replacement in aortic regurgitation. Int J Cardiovasc Imaging 39, 2063–2071 (2023). https://doi.org/10.1007/s10554-023-02908-9

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