CMR assessment after a transapical-transcatheter aortic valve implantation

详细信息    查看全文

• 作者：Lo茂c Biere ; Fr茅d茅ric Pinaud ; St茅phane Del茅pine ; Sylvain Grall ; Nathalie Viot ; Victor Mateus ; Fr茅d茅ric Rouleau ; Jean-Jacques Corbeau ; Fabrice Prunier ; Jean-Louis De Brux ; Serge Willoteaux ; Alain Furber
• 关键词：CMR ; cardiac magnetic resonance imaging ; LGE ; late gadolinium enhancement ; LV ; left ventricle ; TA ; transapical ; TAVI ; transcatheter aortic valve implantation ; TF ; transfemoral
• 刊名：European Journal of Radiology
• 出版年：February, 2014
• 年：2014
• 卷：83
• 期：2
• 页码：303-308
• 全文大小：1190 K

文摘

Aims

To describe the time course of myocardial scarring after transapical-transcatheter aortic valve implantation (TA-TAVI) with the Edwards SAPIEN XT鈩?and the Edwards SAPIEN鈩?prosthesis in a 3-month follow-up study using cardiac magnetic resonance imaging (CMR).

Methods

In 20 TA-TAVI patients, CMR was performed at discharge and 3 months (3M). Cine-MRI was used for left ventricular (LV) functional assessment, and late gadolinium enhancement (LGE) imaging was employed for detecting the presence of myocardial scarring. Special attention was given to any artifacts caused by the prosthesis, which were consequently defined using a three-grade artifact scale.

Results

We systematically reported the presence of small LGE hyperintensity relating to the apical segment, with no variation found between discharge and 3 M (2.8 卤 1.6 g vs. 2.35 卤 1.1 g). LV ejection fraction, end-diastolic, and end-systolic volumes did not significantly vary. A small area of apical akinesia was observed, with no improvement at follow-up. Whereas the Edwards SAPIEN XT鈩?prosthesis and the Edwards SAPIEN鈩?prosthesis are both constituted by metallic stenting structure, the Edwards SAPIEN鈩?was responsible for a larger signal void, thus potentially limiting the diagnostic performance of CMR.

Conclusions

CMR may be performed safely in the context of TA-TAVI. The presence of a very small apical infarction correlating with focal akinesia was observed. As expected, the Edwards SAPIEN XT鈩?prosthesis was shown to be particularly suitable for CMR assessment.