Clinicians have a new tool for predicting TAVR mortality
Left atrium emptying fraction (LAEF) measurements taken from cardiac CT angiography (CTA) exams can help predict transcatheter aortic valve replacement (TAVR) mortality, according to new research published in the American Journal of Roentgenology.
“CT is required for preprocedural workup of patients undergoing TAVR and provides not only information on the arterial access route but also anatomic and morphologic assessment of the aortic valve apparatus for annular prosthesis sizing, positioning of the valve, and determination of risk of annular injury or coronary occlusion,” wrote lead author Gilberto J. Aguino, MD, of the division of cardiovascular imaging at Medical University of South Carolina, and colleagues.
Researchers focused on data from 175 patients with severe aortic stenosis (AS) who were treated at the same facility. Each patient underwent cardiac CTA as part of their pre-TAVR assessment, and LAEF measurements were automatically recorded.
After a median follow-up period of 21 months, a total of 38 TAVR patients had died.
Overall, the team found that a reduced LAEF “independently predicted all-cause mortality within 24 months” of the TAVR. Also, LAEF measurements can be incorporated into the Society of Thoracic Surgeons Predicted Risk of Mortality score to make it even more accurate than before.
“LAEF can be readily assessed using preprocedural cardiac CTA in patients with severe AS undergoing TAVR,” the authors wrote. “Further, LAEF independently predicts overall mortality post-TAVR, thus having potential to further improve risk stratification and post-TAVR surveillance.”
Click here to read the full study in the American Journal of Roentgenology.