Background: Fractional flow reserve-computed tomography (FFR) has not been validated in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) for coronary artery disease due to theoretical difficulties in using nitroglycerin for such patients.
Methods and results: In this single-center study, we prospectively enrolled 21 patients (34 vessels) and performed pre-TAVR FFRwithout nitroglycerin, pre-TAVR invasive instantaneous wave-free ratio (iFR) measurements, and post-TAVR FFR measurements using a pressure wire. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of pre-TAVR FFR≤0.80 to predict post-TAVR invasive FFR ≤0.80 were 82%, 83%, 82%, 71%, and 90%, respectively. A receiver operating characteristic analysis demonstrated an optimal cutoff of 0.78 for pre-TAVR FFRto indicate post-TAVR FFR ≤0.80, with an area under the curve (AUC) of 0.84, and the counterpart cutoff of pre-TAVR iFR was 0.89 with an AUC of 0.86.
Conclusions: FFRwithout nitroglycerin could be a useful non-invasive imaging modality for assessing the severity of coronary artery lesions in patients with severe AS.
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http://dx.doi.org/10.1253/circj.CJ-23-0312 | DOI Listing |
Int J Cardiol Congenit Heart Dis
September 2024
University of Sydney, Camperdown, NSW, 2050, Australia.
Background: Although several National Data Registries for Congenital Heart Disease (CHD) exist, few are comprehensive and contemporary. A National Australian CHD Registry has been developed that aims to redress this by creating the first comprehensive data collection for CHD children and adults, initially across Australia.
Methods: We defined and collected a minimum dataset of demographics, diagnoses, and procedures from people with CHD presenting at participating quaternary CHD services Australia-wide.
BMC Cardiovasc Disord
December 2024
Department of Radiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China.
Background: The aim of this study was to evaluate the prognostic impact of computed tomography (CT)-based body composition parameters in metabolically unhealthy normal-weight patients (MUHNW) with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).
Methods: This prospective cohort study involved adults with normal weight scheduled for TAVR. Patients were divided into two groups: metabolically healthy normal-weight (MHNW) and MUHNW.
Can J Cardiol
December 2024
Cardiology Department, Southlake Regional Health Centre, Newmarket, Ontario, Canada. Electronic address:
Background: Patients with symptomatic aortic stenosis are a vulnerable population with associated cardiac damage and a significant comorbidity burden. This study aimed to determine the rate, factors associated with, and prognostic value of poor functional status (NYHA class III-IV) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).
Methods: This multicenter study included 6,363 transarterial TAVR patients, classified according to baseline functional status (NYHA class I-II vs.
JACC Cardiovasc Interv
November 2024
Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan. Electronic address:
Background: Low-gradient (LG) aortic stenosis (AS) has not been fully characterized compared with high-gradient (HG) AS in terms of cardiac damage, frailty, aortic valve calcification, and clinical outcomes.
Objectives: The aim of this study was to compare the clinical characteristics and outcomes between each hemodynamic type of LG AS and HG AS.
Methods: The current study included 3,363 patients in the CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) Registry-2 after excluding patients without indexed stroke volume or left ventricular ejection fraction (LVEF) data.
Gen Thorac Cardiovasc Surg Cases
December 2024
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan.
Background: With the rapid expansion of transcatheter aortic valve replacement (TAVR), TAVR valve explantation is also increasing. Nevertheless, previous reports on Lotus Edge valve explantation are limited to only two reports, none of which include intraoperative videos. Therefore, we report the case of an older adult who underwent a 2-year-old Lotus Edge valve explantation, after developing prosthetic valve endocarditis (PVE) and aortic annular abscess, with a strong indication for a TAVR explantation and surgical aortic valve replacement (AVR).
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