JACC. Cardiovascular imaging
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JACC Cardiovasc Imaging · Mar 2015
Review Practice GuidelineRecommendations for comprehensive intraprocedural echocardiographic imaging during TAVR.
Recent multicenter trials have shown that transcatheter aortic valve replacement is an alternative to surgery in a high risk population of patients with severe, symptomatic aortic stenosis. Echocardiography and multislice computed tomographic imaging are accepted tools in the pre-procedural imaging of the aortic valve complex and vascular access. Transesophageal echocardiography can be valuable for intraprocedural confirmation of the landing zone morphology and measurements, positioning of the valve and post-procedural evaluation of complications. The current paper provides recommendations for pre-procedural and intraprocedural imaging used in assessing patients for transcatheter aortic valve replacement with either balloon-expandable or self-expanding transcatheter heart valves.
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JACC Cardiovasc Imaging · Mar 2015
Multicenter StudyPrognostic value of LV deformation parameters using 2D and 3D speckle-tracking echocardiography in asymptomatic patients with severe aortic stenosis and preserved LV ejection fraction.
The objective of this study was to determine which strain component assessed by 2-dimensional speckle-tracking echocardiography (2DSTE) and 3-dimensional speckle-tracking echocardiography (3DSTE) was the most powerful predictor for future major adverse cardiac events (MACE) in asymptomatic patients with severe aortic stenosis (AS). ⋯ 3DGLS is the most robust index for predicting future adverse cardiac events in asymptomatic severe AS patients with preserved LVEF.
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JACC Cardiovasc Imaging · Mar 2015
Comparative StudyAortic valve area calculation in aortic stenosis by CT and Doppler echocardiography.
The aim of this study was to verify the hypothesis that multidetector computed tomography (MDCT) is superior to echocardiography for measuring the left ventricular outflow tract (LVOT) and calculating the aortic valve area (AVA) with regard to hemodynamic correlations and survival outcome prediction after a diagnosis of aortic stenosis (AS). ⋯ Head-to-head comparison of MDCT and Doppler echocardiography refutes the hypothesis of MDCT superiority for AVA calculation. AVACT is larger than AVAEcho but does not improve the correlation with transvalvular gradient, the concordance gradient-AVA, or mortality prediction compared with AVAEcho. Larger cut-point values should be used for severe AS if AVACT (<1.2 cm(2)) is measured versus AVAEcho (<1.0 cm(2)).