• Luis F Gonzalez-Ciccarelli, Renan A Ferrufino, Abdulaziz Alfadhel, Ethan Brovman, Jamel Ortoleva, Benjamin S Wessler, Michael Fettiplace, and Frederick Cobey.
• Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
• J. Cardiothorac. Vasc. Anesth. 2024 Jun 1; 38 (6): 130913131309-1313.

ObjectivesTo determine the impact of pressure recovery (PR) adjustment on disease severity grading in patients with severe aortic stenosis. The authors hypothesized that accounting for PR would result in echocardiographic reclassification of aortic stenosis severity in a significant number of patients.DesignA retrospective observational study between October 2013 and February 2021.SettingA single-center, quaternary-care academic center.ParticipantsAdults (≥18 years old) who underwent transcatheter aortic valve implantation (TAVI).InterventionsTAVI.Measurements And Main ResultsA total of 342 patients were evaluated in this study. Left ventricle mass index was significantly greater in patients who continued to be severe after PR (100.47 ± 28.77 v 90.15 ± 24.03, p = < 0.000001). Using PR-adjusted aortic valve area (AVA) resulted in the reclassification of 81 patients (24%) from severe to moderate aortic stenosis (AVA >1.0 cm2). Of the 81 patients who were reclassified, 23 patients (28%) had sinotubular junction (STJ) diameters >3.0 cm.ConclusionAdjusting calculated AVA for PR resulted in a reclassification of a significant number of adult patients from severe to moderate aortic stenosis. PR was significantly larger in patients who reclassified from severe to moderate aortic stenosis after adjusting for PR. PR appeared to remain relevant in patients with STJ ≥3.0 cm. Clinicians need to be aware of PR and how to account for its effect when measuring pressure gradients with Doppler.Copyright © 2024 Elsevier Inc. All rights reserved.

24 keywords...

hide…