Relative amplitude index: A new tool for hemodynamic evaluation of periprosthetic regurgitation after transcatheter valve implantation

Objective The impact of paravalvular aortic regurgitation (PAR) on hemodynamic performance after transcatheter aortic valve implantation (TAVI) remains disputable. Common parameters such as the diastolic blood pressure or the blood pressure amplitude do not provide reproducible results. The aim of o...

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Bibliographic Details
Published in:The Journal of thoracic and cardiovascular surgery 2014-03, Vol.147 (3), p.1021-1029.e2
Main Authors: Heinz, Anneliese, MD, DeCillia, Michael, MS, Feuchtner, Gudrun, MD, Mueller, Silvana, MD, Bartel, Thomas, MD, Friedrich, Guy, MD, Grimm, Michael, MD, Mueller, Ludwig Ch., MD, Bonaros, Nikolaos, MD, PhD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aortic Valve Insufficiency - diagnosis
Aortic Valve Insufficiency - epidemiology
Aortic Valve Insufficiency - mortality
Aortic Valve Insufficiency - physiopathology
Aortic Valve Stenosis - diagnosis
Aortic Valve Stenosis - physiopathology
Aortic Valve Stenosis - therapy
Austria - epidemiology
Blood Pressure
Cardiac Catheterization - adverse effects
Cardiac Catheterization - mortality
Cardiothoracic Surgery
Chi-Square Distribution
Female
Heart Valve Prosthesis Implantation - adverse effects
Heart Valve Prosthesis Implantation - methods
Heart Valve Prosthesis Implantation - mortality
Hemodynamics
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Odds Ratio
Predictive Value of Tests
Proportional Hazards Models
Retrospective Studies
Risk Factors
Severity of Illness Index
Systole
Time Factors
Treatment Outcome
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Summary:Objective The impact of paravalvular aortic regurgitation (PAR) on hemodynamic performance after transcatheter aortic valve implantation (TAVI) remains disputable. Common parameters such as the diastolic blood pressure or the blood pressure amplitude do not provide reproducible results. The aim of our study was to evaluate the impact of PAR on hemodynamics and outcome using the relative amplitude index (RAI). Methods PAR was prospectively evaluated by echocardiography before discharge in 110 patients. The RAI was calculated according to the formula: RAI = [(Post-TAVI BP amplitude)/(Post-TAVI SBP) − (Pre-TAVI BP amplitude)/(Pre-TAVI SBP)] × 100%, where BP is blood pressure and SBP is systolic blood pressure. Correlations of increased RAI with perioperative outcome were investigated and factors influencing mortality were isolated. Results The incidence of moderate and severe PAR after TAVI was 9% and 1%, respectively. Diastolic pressure or post-TAVI amplitude did not correlate to perioperative outcome. RAI increased from 2 when PAR was
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2013.11.011