Video densitometric assessment of aortic regurgitation after transcatheter aortic valve implantation

Aims: We sought to examine the feasibility and reproducibility of a new video densitometric (VD) quantification of aortic regurgitation (AR) on aortography, and its long-Term clinical impact.
Methods and results: Using dedicated video densitometry software, AR after TAVI was quantified, and inter-and intra-observer reproducibility was investigated in 182 aortograms of the Brazilian TAVI registry. The aortograms were analysed using two software algorithms:
1) the quantitative regurgitation analysis (qRA) index interrogating the entire left ventricle (LV), and
2) a new method with the left ventricle outflow tract (LVOT) as a region of interest (ROI) (LVOT-AR).
LVOT-AR was feasible in 64.8% vs. 29.7% of aortograms, compared with qRA index. Using the LVOT-AR, inter-observer variability was low, and the two observers' measurements were highly correlated. Patients with LVOT-AR >0.17 had a significantly higher one-year all-cause mortality risk compared with patients with LVOT-AR ≤0.17.
Conclusions: This study proposes an alternative methodology for AR assessment after TAVI by using the LVOT method (LVOT-AR) of VD angiography. The assessment of LVOT-AR is feasible, reproducible and potentially predictive of one-year mortality.