Virtual Conference
Heart 2022 Conference

Yang Chen

Fuwai Hospital, National Center for Cardiovascular Disease, China

Title: CT Anatomy Characteristics Based on Transcatheter Aortic Valve Replacement in Aortic Regurgitation

Abstract

Objectives: To analyze CT measurement characteristics based on transcatheter aortic valve replacement (TAVR) in patients with aortic regurgitation (AR).

Background: The current functional classification of AR cannot guide TAVR.

Methods: This retrospective cohort study included 144 consecutive patients with moderate to severe AR from July 2017 to April 2022. They were classified into four morphological types based on dual-anchoring multiplanar measurement, type-1 transcatheter heart valve (THV) anchoring at the annulus, left ventricular outflow tract (LVOT), and ascending aorta (AA); type-2 anchoring at the annulus and AA; type-3 anchoring at the annulus and LVOT; and type-4 anchoring at only one level or not anchoring at all. Types 1-3 were considered as candidates for TAVR; type 4 was not.

Results: Patients (n=136) with AR (mean age, 68.7 years ± 10.7; 98 men) included 117 (86.0%) tricuspid, 14 bicuspid, and 5 quadricuspid valves. Dual-anchoring multiplanar measurements showed the annulus shorter than LVOT, 2, 4, 6, 8, and 10 mm on annulus; AA widened with the height of 30–50 mm. For 10% oversize of THV, the proportions of the annulus, LVOT, and AA unable to meet the diameter were 22.8, 37.5, and 50%, and proportions of anatomical classification types 1–4 were 32.4, 5.9, 30.1, and 31.6%, respectively. For 20% oversize, the proportion of type 4 was 59.5%. The newly designed THV could significantly improve the type 1 proportion (88.2%).

Conclusions: Existing THV did not meet the anatomical characteristics of the patients with AR; the newly designed THV could theoretically facilitate TAVR.

Biography

Chen Yang, a doctoral student at the National Center for cardiovascular disease, Fuwai Hospital of the Chinese Academy of Medical Sciences, and Peking Union Medical College, is under Professor Yong-Jian Wu of Fuwai Hospital. My main research interests are imaging evaluation of structural heart disease and interventional treatment of valve disease. Follow professor Wu, one of pioneer of China transcatheter aortic valve replacement (TAVR), to carry out TAVR for patients with aortic valve stenosis and aortic regurgitation. So far, more than 260 cases of TAVR have been followed and more than 400 cases have been independently evaluated. I have rich experience in TAVR preoperative imaging evaluation, operation skills, postoperative management, etc. Participated in 2020 national key special project on senile valvular disease and 2 clinical trials of new device of valves; Participated in the preparation of "clinical pathway 2021 of transcatheter aortic valve replacement in China". In 2021, I became a silver crystal member of the Asia Pacific structural heart disease club.