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Incremental Value of Aortomitral Continuity Calcification for Risk Assessment after Transcatheter Aortic Valve

Martin J Willemink1, Eva Maret1, Kegan J Moneghetti1

  • 1Department of Radiology (M.J.W., E.M., K.H., A.M.S., D.F.), Stanford Cardiovascular Institute (M.J.W., E.M., K.J.M., J.B.K., F.H., Y.K., T.N., K.N., K.H., A.M.S., A.C.Y., A.M.L., D.C.M., M.F., W.F.F., D.F.), Division of Cardiovascular Medicine (J.B.K., F.H., Y.K., T.N., K.N., A.C.Y., W.F.F.), and Department of Cardiothoracic Surgery (A.M.L., D.C.M., M.F.), Stanford University School of Medicine, 300 Pasteur Dr, S-072, Stanford, CA 94305-5105; Department of Clinical Physiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden (E.M.); and Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (N.C., T.K.).

Radiology. Cardiothoracic Imaging
|March 29, 2021
PubMed

Insights

Aortomitral continuity calcification (AMCC) predicts mortality after transcatheter aortic valve replacement (TAVR). Including AMCC in risk models improves patient mortality prediction following TAVR.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
  • Risk stratification for TAVR outcomes is crucial for patient management.
  • Calcification in various cardiac structures may influence TAVR outcomes.

Purpose of the Study:

  • To assess the association of aortomitral continuity calcification (AMCC) with mortality after TAVR.
  • To determine if AMCC predicts postprocedural paravalvular leak (PVL).
  • To investigate the link between AMCC and prolonged hospital stay post-TAVR.

Main Methods:

  • Retrospective analysis of 329 patients undergoing TAVR.
  • Quantification of AMCC, aortic valve calcification (AVC), and coronary artery calcification (CAC) using preprocedural CT scans.
  • Statistical analysis to evaluate associations with 1-year mortality, PVL, and hospital stay.

Main Results:

  • Coronary artery calcification (CAC) and AMCC mass were associated with 1-year mortality.
  • Aortic valve calcification (AVC) mass was linked to postprocedural PVL.
  • Only the Society of Thoracic Surgeons (STS) score predicted prolonged hospital stay.

Conclusions:

  • AMCC is an independent predictor of mortality within one year following TAVR.
  • Incorporating AMCC into risk models significantly enhances the prediction of individual patient mortality.
  • AMCC provides valuable prognostic information beyond traditional risk factors and AVC mass.
Abstract

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