TY  - BOOK
AU  - Ben-Dor, Itsik
AU  - Buchanan, Kyle
AU  - Ertel, Andrew
AU  - Koifman, Edward
AU  - Okubagzi, Petros
AU  - Rogers, Toby
AU  - Satler, Lowell F
AU  - Shults, Christian
AU  - Steinvil, Arie
AU  - Torguson, Rebecca
AU  - Waksman, Ron
AU  - Weigold, William Guy
AU  - Weissman, Gaby
TI  - Accuracy of predicted orthogonal projection angles for valve deployment during transcatheter aortic valve replacement
SN  - 1876-861X
PY  - 2018///
KW  - *Aortic Valve Stenosis/dg [Diagnostic Imaging]
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Aortic Valve/dg [Diagnostic Imaging]
KW  - *Aortic Valve/su [Surgery]
KW  - *Computed Tomography Angiography/mt [Methods]
KW  - *Coronary Angiography/mt [Methods]
KW  - *Multidetector Computed Tomography/mt [Methods]
KW  - *Radiographic Image Interpretation, Computer-Assisted/mt [Methods]
KW  - *Transcatheter Aortic Valve Replacement
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/pp [Physiopathology]
KW  - Aortic Valve/pp [Physiopathology]
KW  - Female
KW  - Heart Valve Prosthesis
KW  - Humans
KW  - Male
KW  - Predictive Value of Tests
KW  - Reproducibility of Results
KW  - Retrospective Studies
KW  - Transcatheter Aortic Valve Replacement/is [Instrumentation]
KW  - MedStar Washington Hospital Center
KW  - Internal Medicine
KW  - MedStar Heart & Vascular Institut
KW  - Journal Article
N2  - BACKGROUND: Multi-detector computed tomography (MDCT) predicted orthogonal projection angles have been introduced to guide valve deployment during transcatheter aortic valve replacement (TAVR). Our aim was to investigate the accuracy of MDCT prediction methods versus actual angiographic deployment angles; CONCLUSIONS: Currently used MDCT methods for TAVR implantation angles are significantly modified before actual valve deployment. Thus, further refinement of these prediction methods is required; Copyright (c) 2018 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved; METHODS: Retrospective analysis of 2 currently used MDCT methods: manual multiplanar reformations (MR) and the semiautomatic optimal angle graph (OAG). Paired analysis was used to compare the 2-dimensional distributions and means; RESULTS: We included 101 patients with a mean (+/-SD) age of 81+/-9 years. The MR and OAG methods were used in 46 and 55 patients, respectively. A >=5% change from the predicted MDCT range in left anterior oblique/right anterior oblique (LAO/RAO) and the cranial/caudal (CRA/CAU) angle occurred in 42% and 58% of patients, respectively. The mean predicted versus actual deployment angles were significantly different (CRA/CAU: -2.6+/-11.5 vs. -7.6+/-10.7, p<0.001; RAO/LAO 8.1+/-10.9 vs. 9.5+/-10.6, p=0.048; respectively). The MR method resulted in a more accurate CRA/CAU angle (CRA/CAU: -4.6+/-11.1 vs. -6.5+/-11.8, p=0.139; RAO/LAO 7.4+/-11.2 vs. 10.4+/-11.2, p=0.008; respectively), whereas the use of the OAG resulted in a more accurate RAO/LAO angle (CRA/CAU: -0.9+/-10.8 vs. -9+/-11.2, p<0.001; RAO/LAO 9.05+/-10.6 vs. 8.5+/-9.9, p=0.458; respectively). For the entire cohort, the 2-dimensional distributions and means of the predicted versus the actual angles were significantly different from each other (p<0.001). We repeated our analysis using both MDCT methods and demonstrated similar results with each method
UR  - https://dx.doi.org/10.1016/j.jcct.2018.05.017
ER  -