Evaluation of a Low-Dose Radiation Protocol During Transcatheter Aortic Valve Implantation
Section snippets
Methods
This observational intention-to-treat analysis included patients who underwent transfemoral TAVI using the Sapien 3 (Edwards Lifesciences, Irvine, CA) balloon-expandable transcatheter heart valve (THV) at the Clinic for Heart and Circulatory Disorders, at the high-volume German Heart Centre in Munich, Germany. All patients receiving ≥23 mm balloon-expandable Sapien 3 THVs were eligible for inclusion. A reference group of consecutive patients treated between January 2014 and February 2016 using
Results
After exclusions, 802/819 (97.9%) patients were evaluated; comparative analysis was performed on propensity score matched pairs (Figure 2). The median age of the unmatched population was 80 (77, 84) years, 40.9% female, median weight 75 kg (67, 86), median BMI 26.1 kg/m2(23.7, 29.4), with a median logistic EuroSCORE of 13.48% (7.96 to 22.76).
Baseline characteristics for the overall patient cohort, the 2 unmatched imaging protocol subgroups (SD, n = 449; LD, n = 353), and the propensity matched
Discussion
Patient radiation dose from high-dose procedures such as structural heart interventions will vary depending on case complexity,19 operator experience,20,21 imaging device settings,22,23 and age of the imaging system.1,24 This study aimed to determine the impact of a low-dose imaging protocol developed for TAVI on procedural DAP in a large cohort of patients. The primary finding is that, compared with a SD protocol, use of the LD protocol resulted in a large reduction in median DAP, in a
Author Contribution
Jonathan M. Michel: Conceptualization, Methodology, Data Curation, Investigation, Formal Analysis, Writing – Original Draft, Writing - Review & Editing
Desard Hashorva: Investigation
Angela Kretschmer: Methodology, Investigation, Writing - Review & Editing
Hector A. Alvarez- Covarrubias: Methodology, Data Curation, Investigation, Writing - Review & Editing
N. Patrick Mayr: Writing - Review & Editing
Costanza Pellegrini: Investigation, Software, Writing - Review & Editing
Tobias Rheude: Investigation,
Disclosures
This study was performed without external or industry funding. Dr. Michel has received honoraria from Edwards Lifesciences. Dr. Kasel is a consultant and proctor for Edwards Lifesciences. Dr. Frangieh is a consultant and proctor for Edwards Lifesciences. The remaining authors report no disclosures.
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Fluoroscopy Time as a New Predictor of Short-Term Outcomes after Transcatheter Aortic Valve Replacement
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