TAVI-CT score to evaluate the anatomic risk in patients undergoing transcatheter aortic valve implantation.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
09 05 2022
Historique:
received: 07 11 2021
accepted: 07 04 2022
entrez: 9 5 2022
pubmed: 10 5 2022
medline: 12 5 2022
Statut: epublish

Résumé

Transcatheter aortic valve implantation (TAVI) requires thorough preprocedural planning with non-invasive imaging, including computed tomography (CT). The plethora of details obtained with thoraco-abdominal CT represents a challenge for accurate and synthetic decision-making. We devised and tested a comprehensive score suitable to summarize CT exams when planning TAVI. An original comprehensive scoring system (TAVI-CT score) was devised, including details on cardiac, aortic, iliac and femoral artery features. The score was applied to a prospectively collected series of patients undergoing TAVI at our institution, driving decision making on access and prosthesis choice. Different TAVI-CT score groups were compared in terms of procedural success, acute complications, and early clinical outcomes. We included a total of 200 undergoing TAVI between February 2020 and May 2021, with 74 (37.0%) having a low (0-2) TAVI-CT score, 50 (25.0%) having a moderate (3) TAVI-CT score, and 76 (38.0%) having a high (≥ 4) TAVI-CT score. Male gender was the only non-CT variable significantly associated with the TAVI-CT score (p = 0.001). As expected, access choice differed significantly across TAVI-CT scores (p = 0.009), as was device choice, with Portico more favored and Allegra less favored in the highest TAVI-CT score group (p = 0.036). Acute outcomes were similar in the 3 groups, including device and procedural success rates (respectively p = 0.717 and p = 1). One-month follow-up showed similar rates of death, myocardial infarction, stroke, and bleeding, as well as of a composite safety endpoint (all p > 0.05). However, vascular complications were significantly more common in the highest TAVI-CT score group (p = 0.041). The TAVI-CT score is a simple scoring system that could be routinely applied to CT imaging for TAVI planning, if the present hypothesis-generating findings are confirmed in larger prospective studies.

Identifiants

pubmed: 35534616
doi: 10.1038/s41598-022-11788-3
pii: 10.1038/s41598-022-11788-3
pmc: PMC9085825
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

7612

Informations de copyright

© 2022. The Author(s).

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Auteurs

Nicola Corcione (N)

Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.

Alberto Morello (A)

Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.

Paolo Ferraro (P)

Unità Operativa di Emodinamica, Santa Lucia Hospital, San Giuseppe Vesuviano, Italy.

Michele Cimmino (M)

Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.

Michele Albanese (M)

Unità Operativa di Emodinamica, Santa Lucia Hospital, San Giuseppe Vesuviano, Italy.

Martino Pepe (M)

Division of Cardiology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.

Palma Luisa Nestola (PL)

Division of Cardiology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.

Salvatore Giordano (S)

Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. sasigiordano@gmail.com.

Luca Bardi (L)

Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.

Giuseppe Biondi-Zoccai (G)

Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
Mediterranea Cardiocentro, Naples, Italy.

Arturo Giordano (A)

Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.

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Classifications MeSH