Quantitative aortography for assessing aortic regurgitation after transcatheter aortic valve implantation: results of the multicentre ASSESS-REGURGE Registry

Aims: Quantitative aortography using videodensitometry is a valuable tool for quantifying paravalvular regurgitation after TAVI, especially in the minimalist approach – without general anaesthesia. However, retrospective assessment of aortograms showed moderate feasibility of assessment. We sought to determine the prospective feasibility of quantitative aortography after a protocol of acquisition. Methods and results: 7KLV ZDV D PXOWLFHQWUH UHJLVWU\ LQ -DSDQ &DQDGD WKH 1HWKHUODQGV DQG *HUPDQ\ LQFOXGLQJFRQVHFXWLYHSDWLHQWVZLWK+HDUW7HDPLQGLFDWLRQWRXQGHUJR7$9,RYHUDPHGLDQSHULRGRIPRQWKV 2SHUDWRUVSHUIRUPHGILQDODRUWRJUDPVDFFRUGLQJWRDSUHSODQQHGSURMHFWLRQHLWKHUE\&7RUYLVXDOO\±7HQJ¶V rule). An independent core laboratory (Cardialysis) analysed all images for feasibility and for regurgitation DVVHVVPHQW)URPWKH IRXUFHQWUHVLQFOXGHGLQWKH SUHVHQWDQDO\VLVDWRWDO RI SDWLHQWV XQGHUZHQW7$9, following the acquisition protocol and all the aortograms were analysed by the core lab. The analyses were IHDVLEOHLQFRQILGHQFHLQWHUYDO>&,@WRRIWKHFDVHV7KLVUDWHRIDQDO\VDEOHDVVHVVment was significantly higher than the feasibility in previous validation studies, such as in the RESPOND SRSXODWLRQ YV S1R GLIIHUHQFHVZHUH REVHUYHGDPRQJ GLIIHUHQW SODQQLQJ VWUDWHJLHV &7YV7HQJ¶VUXOHS RU&LUFOHYVPHQVLRYV7HQJ¶VUXOHS Conclusions: ASSESS-REGURGE showed a high feasibility of assessment of regurgitation with quantitative aortography with protocoled acquisition. This may be of great importance for quantifying regurgitation in TAVI procedures (optimisation, guidance of post-dilatation), and in future clinical trials, in order to DGGUHVVVHDOLQJIHDWXUHVRIQRYHOGHYLFHVIRU7$9,REMHFWLYHO\&OLQLFDO7ULDOVJRY,GHQWLILHU1&7

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