Distance between valvular leaflet and coronary ostium predicting risk of coronary obstruction during TAVR

Background: The aim of this study was to evaluate the role of the distance between the aortic valve in projected position to the coronary ostium to determine risk of coronary artery obstruction after transcatheter aortic valve replacement (TAVR). Methods: An Expected Leaflet-to-ostium Distance (ELOD...

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Autores principales:	Jun-Hyok Oh, Yuhei Kobayashi, Guson Kang, Takeshi Nishi, Martin J. Willemink, William F. Fearon, Michael Fischbein, Dominik Fleishmann, Alan C. Yeung, Juyong Brian Kim
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	TAVR Coronary artery Obstruction Distance Height Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/3f88e0a0cf3a407b8646de744ce87273
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spelling	oai:doaj.org-article:3f88e0a0cf3a407b8646de744ce872732021-12-02T05:02:10ZDistance between valvular leaflet and coronary ostium predicting risk of coronary obstruction during TAVR2352-906710.1016/j.ijcha.2021.100917https://doaj.org/article/3f88e0a0cf3a407b8646de744ce872732021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352906721002050https://doaj.org/toc/2352-9067Background: The aim of this study was to evaluate the role of the distance between the aortic valve in projected position to the coronary ostium to determine risk of coronary artery obstruction after transcatheter aortic valve replacement (TAVR). Methods: An Expected Leaflet-to-ostium Distance (ELOD) was obtained on pre-TAVR planning computed tomography by subtracting leaflet thickness and the distances from the center to the annular rim at annulus level and from the center to the coronary ostium at mid-ostial level. Variables were compared between patients with and without coronary obstruction and the level of association between variables was assessed using log odds ratio (OR). Results: A total of 177 patients with 353 coronary arteries was analyzed. Mean annulus diameters (22.8 ± 2.8 mm and 23.4 ± 1.0 mm, p > 0.05) and mean sinus of Valsalva (SOV) diameters (31.2 ± 3.6 mm and 31.9 ± 3.6 mm, p > 0.05) were similar between patients with lower and higher coronary heights, respectively. There were three coronary obstruction cases. ELOD ≤ 2 mm in combination with leaflet length longer than mid-ostial height allowed for discrimination of cases with and without coronary obstruction. There was a significant association between coronary obstruction event and ELOD ≤ 2 mm (log OR = 6.180, p < 0.001). Conclusions: Our study showed that a combination of ELOD < 2 mm and a longer leaflet length than mid-ostial height may be associated with increased risk for coronary obstruction during TAVR.Jun-Hyok OhYuhei KobayashiGuson KangTakeshi NishiMartin J. WilleminkWilliam F. FearonMichael FischbeinDominik FleishmannAlan C. YeungJuyong Brian KimElsevierarticleTAVRCoronary arteryObstructionDistanceHeightDiseases of the circulatory (Cardiovascular) systemRC666-701ENInternational Journal of Cardiology: Heart & Vasculature, Vol 37, Iss , Pp 100917- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	TAVR Coronary artery Obstruction Distance Height Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	TAVR Coronary artery Obstruction Distance Height Diseases of the circulatory (Cardiovascular) system RC666-701 Jun-Hyok Oh Yuhei Kobayashi Guson Kang Takeshi Nishi Martin J. Willemink William F. Fearon Michael Fischbein Dominik Fleishmann Alan C. Yeung Juyong Brian Kim Distance between valvular leaflet and coronary ostium predicting risk of coronary obstruction during TAVR
description	Background: The aim of this study was to evaluate the role of the distance between the aortic valve in projected position to the coronary ostium to determine risk of coronary artery obstruction after transcatheter aortic valve replacement (TAVR). Methods: An Expected Leaflet-to-ostium Distance (ELOD) was obtained on pre-TAVR planning computed tomography by subtracting leaflet thickness and the distances from the center to the annular rim at annulus level and from the center to the coronary ostium at mid-ostial level. Variables were compared between patients with and without coronary obstruction and the level of association between variables was assessed using log odds ratio (OR). Results: A total of 177 patients with 353 coronary arteries was analyzed. Mean annulus diameters (22.8 ± 2.8 mm and 23.4 ± 1.0 mm, p > 0.05) and mean sinus of Valsalva (SOV) diameters (31.2 ± 3.6 mm and 31.9 ± 3.6 mm, p > 0.05) were similar between patients with lower and higher coronary heights, respectively. There were three coronary obstruction cases. ELOD ≤ 2 mm in combination with leaflet length longer than mid-ostial height allowed for discrimination of cases with and without coronary obstruction. There was a significant association between coronary obstruction event and ELOD ≤ 2 mm (log OR = 6.180, p < 0.001). Conclusions: Our study showed that a combination of ELOD < 2 mm and a longer leaflet length than mid-ostial height may be associated with increased risk for coronary obstruction during TAVR.
format	article
author	Jun-Hyok Oh Yuhei Kobayashi Guson Kang Takeshi Nishi Martin J. Willemink William F. Fearon Michael Fischbein Dominik Fleishmann Alan C. Yeung Juyong Brian Kim
author_facet	Jun-Hyok Oh Yuhei Kobayashi Guson Kang Takeshi Nishi Martin J. Willemink William F. Fearon Michael Fischbein Dominik Fleishmann Alan C. Yeung Juyong Brian Kim
author_sort	Jun-Hyok Oh
title	Distance between valvular leaflet and coronary ostium predicting risk of coronary obstruction during TAVR
title_short	Distance between valvular leaflet and coronary ostium predicting risk of coronary obstruction during TAVR
title_full	Distance between valvular leaflet and coronary ostium predicting risk of coronary obstruction during TAVR
title_fullStr	Distance between valvular leaflet and coronary ostium predicting risk of coronary obstruction during TAVR
title_full_unstemmed	Distance between valvular leaflet and coronary ostium predicting risk of coronary obstruction during TAVR
title_sort	distance between valvular leaflet and coronary ostium predicting risk of coronary obstruction during tavr
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/3f88e0a0cf3a407b8646de744ce87273
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Distance between valvular leaflet and coronary ostium predicting risk of coronary obstruction during TAVR

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