Document Type

Conference Proceeding - Restricted Access

Publication Date

9-20-2022

Publication Title

Journal of the American College of Cardiology

Abstract

Background

Discordance is the discrepancy and often overestimation of the echocardiography-derived transaortic mean gradient (MG) compared with direct invasive measurement. It has been reported in aortic stenosis (AS) and post–transcatheter aortic valve replacement (TAVR). Pressure recovery (PR) has been proposed to explain this discordance

Methods

We included patients with severe AS presenting for TAVR. Invasive MG (IMG) at the level of the aortic valve (A), midascending aorta (B), ascending aorta and aortic arch junction (C), and aortic arch and descending aorta (D) junction was obtained using standardized invasive hemodynamics with 2 pigtails. Echocardiographic and IMG were compared at points A, B, C, and D pre- and post-TAVR. The aortic valve area (AVA) and noninvasive MG were obtained by echocardiography, and the AAA was obtained

Results

Twenty-five patients were included. Pre-TAVR, there was no difference between echocardiography and IMG at level A (P = 0.49) and B (P = 0.06). However, echocardiography overestimated IMG at C (P = 0.004) and D (P = 0.0008). There was no difference between the discordance between echocardiography and IMG at level D and NIPR (P = 0.18) (Figure). Post-TAVR, echocardiography overestimated IMG at level A, B, C, and D (P < 0.05). There was a difference between the discordance at level D and NIPR (P =

Conclusion

In severe AS, discordance between echocardiography and IMG is explained by PR. However, post-TAVR, discordance is not simply explained by PR.

Volume

80

Issue

12 Suppl

First Page

B147

Comments

34th Annual Symposium Transcatheter Cardiovascular Therapeutics Symposium, September 16-19, 2022, Boston MA.

Last Page

B148

DOI

10.1016/j.jacc.2022.08.430

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