Relevance of Motion Artifacts in Planning Computed Tomography on Outcomes After Transcatheter Aortic Valve Implantation.
Aortic stenosis
Computed tomography
Motion artifacts
Preprocedural planning
TAVI
Journal
Structural heart : the journal of the Heart Team
ISSN: 2474-8714
Titre abrégé: Struct Heart
Pays: United States
ID NLM: 101743256
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
03
07
2022
revised:
12
06
2023
accepted:
22
06
2023
medline:
4
12
2023
pubmed:
4
12
2023
entrez:
4
12
2023
Statut:
epublish
Résumé
Motion artifacts in planning computed tomography (CT) for transcatheter aortic valve implantation (TAVI) can potentially skew measurements required for procedural planning. Whether such artifacts may affect safety or efficacy has not been studied. We conducted a retrospective analysis of 852 consecutive patients (mean age, 82 years; 47% women) undergoing TAVI-planning CT at a tertiary care center. Two independent observers divided CTs according to the presence of motion artifacts at the annulus level (Motion vs. Normal group). Endpoints included surrogate markers for inappropriate valve selection: annular rupture, valve embolization or misplacement, need for a new permanent pacemaker, paravalvular leak (PVL), postprocedural transvalvular gradient, all-cause death. Forty-six (5.4%) patients presented motion artifacts on TAVI-planning CT (Motion group). These patients had more preexisting heart failure, moderate-severe mitral regurgitation, and atrial fibrillation. Interobserver variability of annular measurement (Normal vs. Motion group) did not differ for mean annular diameter but was significantly different for perimeter and area. Presence of motion artifacts on planning CT did not affect the prevalence of PVL (≥moderate PVL 0% vs. 2.5% Motion artifacts on planning CT were found in about 5% of patients. Measurements for valve selection were possible without the need for repeat CT, with mean diameter-derived annulus measurement being the most accurate. Motion artifacts were not associated with worse outcomes.
Sections du résumé
Background
UNASSIGNED
Motion artifacts in planning computed tomography (CT) for transcatheter aortic valve implantation (TAVI) can potentially skew measurements required for procedural planning. Whether such artifacts may affect safety or efficacy has not been studied.
Methods
UNASSIGNED
We conducted a retrospective analysis of 852 consecutive patients (mean age, 82 years; 47% women) undergoing TAVI-planning CT at a tertiary care center. Two independent observers divided CTs according to the presence of motion artifacts at the annulus level (Motion vs. Normal group). Endpoints included surrogate markers for inappropriate valve selection: annular rupture, valve embolization or misplacement, need for a new permanent pacemaker, paravalvular leak (PVL), postprocedural transvalvular gradient, all-cause death.
Results
UNASSIGNED
Forty-six (5.4%) patients presented motion artifacts on TAVI-planning CT (Motion group). These patients had more preexisting heart failure, moderate-severe mitral regurgitation, and atrial fibrillation. Interobserver variability of annular measurement (Normal vs. Motion group) did not differ for mean annular diameter but was significantly different for perimeter and area. Presence of motion artifacts on planning CT did not affect the prevalence of PVL (≥moderate PVL 0% vs. 2.5%
Conclusions
UNASSIGNED
Motion artifacts on planning CT were found in about 5% of patients. Measurements for valve selection were possible without the need for repeat CT, with mean diameter-derived annulus measurement being the most accurate. Motion artifacts were not associated with worse outcomes.
Identifiants
pubmed: 38046862
doi: 10.1016/j.shj.2023.100214
pii: S2474-8706(23)00100-8
pmc: PMC10692358
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100214Informations de copyright
© 2023 The Author(s).
Déclaration de conflit d'intérêts
Mathias Wolfrum serves as a proctor for Biosensors. Matthias Bossard has received speaker fees from Abbott Vascular, Amgen, Astra Zeneca, Bayer, Daichii-Sankyo, Mundipharma, and SIS Medical. Stefan Toggweiler serves as a proctor and consultant for Abbott, Biosensors, Boston Scientific, and Medtronic, as a consultant for Shockwave, Teleflex, Medira, atHeart, and Veosource, has received institutional research grants from Boston Scientific and Fumedica AG, and holds equity in Hi-D Imaging. The other authors declare no conflict of interest.
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