Computed Tomography Annular Dimensions: A Novel Method to Compare Prosthetic Valve Hemodynamics

G. Michael Deeb, Jeffrey J. Popma, Stanley J. Chetcuti, Steven J. Yakubov, Mubashir Mumtaz, Thomas G. Gleason, Mathew R. Williams, Hemal Gada, Jae K. Oh, Shuzhen Li, Michael J. Boulware, Arie Pieter Kappetein, Michael J. Reardon

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: The Cardiac Surgical Societies Valve Labeling Task Force consensus document acknowledged inconsistent sizing and labeling of prosthetic heart valves. This study compared the labeled size, internal diameter, and hemodynamics of different surgical and transcatheter valve types implanted into the same size annulus, measured by preprocedural computed tomography (CT). Methods: Patients were retrospectively sorted into 3 CT annular diameter size groups: small (less than 23 mm), medium (23 to less than 26 mm), and large (26 mm or greater). Surgical valves were sorted into 4 categories based on tissue and design: (stentless porcine, standard stented bovine, wraparound stented bovine, and stented porcine). Comparisons were made within the surgical types and with a transcatheter valve. Echocardiograms were independently assessed and CTs were centrally measured. Results: We analyzed 726 surgical and 923 transcatheter valve paired data sets. Among the various valve types implanted into the same size CT annulus, there were significant differences regarding size, internal diameter, and hemodynamics within all 3 size groups. Root enlargement procedures occurred in 1.2% with no differences across valve types or size groups. Transcatheter valve hemodynamics were similar to stentless valves and were significantly better than all stented valves. There was no difference in hemodynamics between the 2 bovine stented valve types, and stented porcine valves were inferior to all valve types. Conclusions: This study documents that prosthetic heart valve sizing and labeling inconsistencies exist. Use of preoperative CT annular dimensions is the most accurate method to compare size, internal diameter, and hemodynamics of bioprosthetic aortic valves because it compares values among various valve types implanted into the same size annulus.

Original languageEnglish (US)
Pages (from-to)1502-1510
Number of pages9
JournalAnnals of Thoracic Surgery
Volume110
Issue number5
DOIs
StatePublished - Nov 2020

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Computed Tomography Annular Dimensions: A Novel Method to Compare Prosthetic Valve Hemodynamics'. Together they form a unique fingerprint.

Cite this