A Retrospective Analysis Assessing Paravalvular Leak and Pacemaker Implantation Using TEE and Non‐Contrast CT for CKD Patients Compared With CT Angiography for Annular Sizing Pre‐TAVR
ABSTRACT Background and Aims Transcatheter aortic valve replacement (TAVR) has become the treatment of choice for many patients with severe aortic stenosis. Proper pre‐procedure sizing of the aortic annulus is crucial in preventing post‐TAVR complications. This is typically performed with CT angiogr...
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Wiley
2025-05-01
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| Series: | Health Science Reports |
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| Online Access: | https://doi.org/10.1002/hsr2.70847 |
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| author | Michael O'Shaughnessy Roxana Tabrizi Derek Pham Nicholas Jackson Olcay Aksoy Andre Akhondi Jeanne Huchting Richard Shemin Murray Kwon Peyman Benharash Brandon Kim Amir Rabbani |
| author_facet | Michael O'Shaughnessy Roxana Tabrizi Derek Pham Nicholas Jackson Olcay Aksoy Andre Akhondi Jeanne Huchting Richard Shemin Murray Kwon Peyman Benharash Brandon Kim Amir Rabbani |
| author_sort | Michael O'Shaughnessy |
| collection | DOAJ |
| description | ABSTRACT Background and Aims Transcatheter aortic valve replacement (TAVR) has become the treatment of choice for many patients with severe aortic stenosis. Proper pre‐procedure sizing of the aortic annulus is crucial in preventing post‐TAVR complications. This is typically performed with CT angiography, but the use of contrast is controversial in patients with chronic kidney disease (CKD). Methods This study of 557 patients from 2016 to 2021 sought to evaluate a contrast‐sparing protocol for balloon expandable TAVR evaluation in patients with CKD, in which patients with glomerular filtration rate of less than 40 would undergo transesophageal echocardiogram (TEE) and CT without contrast (83 patients) for aortic annular sizing instead of CT angiography (445 patients). Results We found that there was no significant difference in rates of greater than trace or greater than mild paravalvular leak between the two groups at hospital discharge, 30 days, or 1‐year post‐TAVR. We also found no difference in rates of permanent pacemaker implantation at these same time points. Conclusions This suggests that TEE and non‐contrast CT could be a viable alternative to CTA in patients with CKD, although more research into other variables such as mortality and other post‐procedural complications is necessary. |
| format | Article |
| id | doaj-art-23d6c4eb240747fbb0c92dffdfcbddeb |
| institution | Kabale University |
| issn | 2398-8835 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Science Reports |
| spelling | doaj-art-23d6c4eb240747fbb0c92dffdfcbddeb2025-08-20T03:59:36ZengWileyHealth Science Reports2398-88352025-05-0185n/an/a10.1002/hsr2.70847A Retrospective Analysis Assessing Paravalvular Leak and Pacemaker Implantation Using TEE and Non‐Contrast CT for CKD Patients Compared With CT Angiography for Annular Sizing Pre‐TAVRMichael O'Shaughnessy0Roxana Tabrizi1Derek Pham2Nicholas Jackson3Olcay Aksoy4Andre Akhondi5Jeanne Huchting6Richard Shemin7Murray Kwon8Peyman Benharash9Brandon Kim10Amir Rabbani11Department of Medicine David Geffen School of Medicine Los Angeles California USADepartment of Medicine David Geffen School of Medicine Los Angeles California USADepartment of Medicine, Division of General Internal Medicine and Health Services Research David Geffen School of Medicine Los Angeles California USADepartment of Medicine, Division of General Internal Medicine and Health Services Research David Geffen School of Medicine Los Angeles California USADepartment of Medicine, Division of Cardiology David Geffen School of Medicine Los Angeles California USADepartment of Medicine, Division of Cardiology David Geffen School of Medicine Los Angeles California USADepartment of Medicine, Division of Cardiology David Geffen School of Medicine Los Angeles California USADepartment of Surgery, Division of Cardiac Surgery David Geffen School of Medicine Los Angeles California USADepartment of Surgery, Division of Cardiac Surgery David Geffen School of Medicine Los Angeles California USADepartment of Surgery, Division of Cardiac Surgery David Geffen School of Medicine Los Angeles California USAUniversity of California Los Angeles California USADepartment of Medicine, Division of Cardiology David Geffen School of Medicine Los Angeles California USAABSTRACT Background and Aims Transcatheter aortic valve replacement (TAVR) has become the treatment of choice for many patients with severe aortic stenosis. Proper pre‐procedure sizing of the aortic annulus is crucial in preventing post‐TAVR complications. This is typically performed with CT angiography, but the use of contrast is controversial in patients with chronic kidney disease (CKD). Methods This study of 557 patients from 2016 to 2021 sought to evaluate a contrast‐sparing protocol for balloon expandable TAVR evaluation in patients with CKD, in which patients with glomerular filtration rate of less than 40 would undergo transesophageal echocardiogram (TEE) and CT without contrast (83 patients) for aortic annular sizing instead of CT angiography (445 patients). Results We found that there was no significant difference in rates of greater than trace or greater than mild paravalvular leak between the two groups at hospital discharge, 30 days, or 1‐year post‐TAVR. We also found no difference in rates of permanent pacemaker implantation at these same time points. Conclusions This suggests that TEE and non‐contrast CT could be a viable alternative to CTA in patients with CKD, although more research into other variables such as mortality and other post‐procedural complications is necessary.https://doi.org/10.1002/hsr2.70847aortic stenosispacemaker implantationparavalvular leakTAVRtranscatheter aortic valve replacement |
| spellingShingle | Michael O'Shaughnessy Roxana Tabrizi Derek Pham Nicholas Jackson Olcay Aksoy Andre Akhondi Jeanne Huchting Richard Shemin Murray Kwon Peyman Benharash Brandon Kim Amir Rabbani A Retrospective Analysis Assessing Paravalvular Leak and Pacemaker Implantation Using TEE and Non‐Contrast CT for CKD Patients Compared With CT Angiography for Annular Sizing Pre‐TAVR Health Science Reports aortic stenosis pacemaker implantation paravalvular leak TAVR transcatheter aortic valve replacement |
| title | A Retrospective Analysis Assessing Paravalvular Leak and Pacemaker Implantation Using TEE and Non‐Contrast CT for CKD Patients Compared With CT Angiography for Annular Sizing Pre‐TAVR |
| title_full | A Retrospective Analysis Assessing Paravalvular Leak and Pacemaker Implantation Using TEE and Non‐Contrast CT for CKD Patients Compared With CT Angiography for Annular Sizing Pre‐TAVR |
| title_fullStr | A Retrospective Analysis Assessing Paravalvular Leak and Pacemaker Implantation Using TEE and Non‐Contrast CT for CKD Patients Compared With CT Angiography for Annular Sizing Pre‐TAVR |
| title_full_unstemmed | A Retrospective Analysis Assessing Paravalvular Leak and Pacemaker Implantation Using TEE and Non‐Contrast CT for CKD Patients Compared With CT Angiography for Annular Sizing Pre‐TAVR |
| title_short | A Retrospective Analysis Assessing Paravalvular Leak and Pacemaker Implantation Using TEE and Non‐Contrast CT for CKD Patients Compared With CT Angiography for Annular Sizing Pre‐TAVR |
| title_sort | retrospective analysis assessing paravalvular leak and pacemaker implantation using tee and non contrast ct for ckd patients compared with ct angiography for annular sizing pre tavr |
| topic | aortic stenosis pacemaker implantation paravalvular leak TAVR transcatheter aortic valve replacement |
| url | https://doi.org/10.1002/hsr2.70847 |
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