Influence of Cardiac Phase on Valve-to-Coronary Ostia Distance in Valve-in-Valve Transcatheter Aortic Valve Replacement
Farah Cadour, Felipe Castillo, Mini Pakkal, Felipe Soares Torres, Jaydeep HalankarPurpose:
No consensus exists on which cardiac phase to use for virtual valve-to-coronary ostium (VTC) distance measurement to predict risk of coronary obstruction in valve-in-valve (ViV). Our study aimed to investigate whether cardiac phase influences VTC measurements in ViV for failing stented surgical heart valves (SHV).
Methods:
All adult patients with stented SHV referred for a pre-planning CT for ViV between 2020 and 2025 were retrospectively eligible. For each patient, VTC was measured for two transcatheter heart valve options at both the right and left coronary ostia. VTC measurements were compared between systole, diastole, and phase with best image quality (best phase). Prevalence of changes in coronary obstruction risk (based on 4-mm cutoff) depending on the phase was assessed. Inter- and intraobserver reliability was evaluated.
Results:
A total of 398 VTC measurements derived from 116 included patients (69 male, 71 ± 13 years) were evaluated. Best phase was more often diastolic. Median VTCs differed between systole and diastole (
Conclusions:
VTC measurements differed and were slightly higher in systole than in diastole, which may influence the coronary obstruction risk classification.