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A novel approach to quantification of aortic valve calcifications in patients undergoing transcatheter aortic valve

Agata Wiktorowicz1, Adrian Wit2, Artur Dziewierz1

  • 1Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland.

Minerva Cardioangiologica
|September 19, 2018
PubMed

Insights

A new semi-automatic algorithm using multi-slice computed tomography (MSCT) effectively quantifies aortic valve calcifications (AVC). This method aids in predicting paravalvular leak (PVL) after transcatheter aortic valve implantation (TAVI).

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Accurate assessment of aortic valve calcifications (AVC) is challenging.
  • Severe aortic stenosis (AS) often requires transcatheter aortic valve implantation (TAVI).

Purpose of the Study:

  • To evaluate a novel semi-automatic algorithm for quantitative estimation of AVC using multi-slice computed tomography (MSCT).
  • To assess the algorithm's utility in predicting paravalvular leak (PVL) after TAVI in patients with severe AS.

Main Methods:

  • Ten patients with severe AS undergoing TAVI were included.
  • Pre-procedural MSCT scans were analyzed using a dedicated program for 3D modeling of AVC (volume, thickness, area, density, distribution).

Main Results:

  • Significant correlation found between maximal calcium thickness and PVL occurrence (P=0.039).
  • Higher AVC in zones with PVL ≥2 compared to zones with PVL <2 (P=0.018).
  • Optimal AVC cut-off (>6506 pixels) predicted PVL ≥2 with 90.5% specificity (AUC 0.762, P=0.029).

Conclusions:

  • Multiplane quantitative AVC evaluation provides detailed insights into calcium amount, pattern, and distribution.
  • Established AVC parameters enhance visualization and prediction of PVL following TAVI.
Abstract

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