Généreux Philippe, Kipperman Robert M, Placido Disla Jenny S, Aldaia Lillian, Koulogiannis Konstantinos P, Marcoff Leo, Mediratta Anuj, Slater James P, Zaku Bledi, Redfors Björn, Abdelfattah Omar M, Gillam Linda D
Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey.
Cardiovascular Research Foundation, New York, New York.
J Soc Cardiovasc Angiogr Interv. 2022 May 17;1(4):100309. doi: 10.1016/j.jscai.2022.100309. eCollection 2022 Jul-Aug.
We aim to establish the degree of agreement related to gradient measurement during transcatheter aortic valve replacement (TAVR) between the OpSens OptoWire III and its new proprietary TAVR algorithm and hemodynamic value derived by catheterization and echocardiogram (transthoracic echocardiogram and transesophageal echocardiogram).
The current study was a prospective, single-arm, single-center study. All subjects underwent hemodynamic assessment before and after TAVR using standard hemodynamic assessment using 2 pigtails, transthoracic echocardiogram, transesophageal echocardiogram, and the OpSens OptoWire III. The primary end point was the final post-TAVR mean gradient correlation between OpSens OptoWire III and hemodynamic values derived by catheterization.
Between July 2021 and September 2021, 20 patients were enrolled. The median age was 79 [6.5] years, and 9 (45%) patients were female. The mean gradient before TAVR derived by 2-pigtail technique and the mean gradient using the OpSens OptoWire III were similar (35 ± 14 mm Hg vs 35 ± 14 mm Hg, = 1.00), with an absolute mean difference of 2.2 ± 3.5 mm Hg and a strong correlation ( = 0.96, < .0001). After TAVR, the mean gradient derived by 2-pigtail technique and the mean gradient using the OpSens OptoWire III were similar (2.2 ± 3.5 vs 2.8 ± 2.7, = .16), with an absolute mean difference of 1.2 ± 1.3 mm Hg and a strong correlation ( = 0.89, < .0001).
Hemodynamic assessment derived by the OpSens OptoWire III wire and its new TAVR algorithm demonstrated excellent correlation with measurements derived by 2 pigtails both before and after TAVR. Integration of this new technology within a dedicated TAVR wire with live hemodynamic assessment could bring meaningful value to TAVR operators.
我们旨在确定经导管主动脉瓣置换术(TAVR)期间,OpSens OptoWire III及其新的专有TAVR算法与通过心导管检查和超声心动图(经胸超声心动图和经食管超声心动图)得出的血流动力学值之间的梯度测量一致性程度。
本研究为前瞻性、单臂、单中心研究。所有受试者在TAVR前后均使用两根猪尾导管进行标准血流动力学评估、经胸超声心动图、经食管超声心动图以及OpSens OptoWire III进行血流动力学评估。主要终点是TAVR术后OpSens OptoWire III与通过心导管检查得出的血流动力学值之间的最终平均梯度相关性。
2021年7月至2021年9月期间,共纳入20例患者。中位年龄为79[6.5]岁,9例(45%)为女性。通过双猪尾技术得出的TAVR术前平均梯度与使用OpSens OptoWire III得出的平均梯度相似(35±14 mmHg对35±14 mmHg,P = 1.00),绝对平均差为2.2±3.5 mmHg,且相关性很强(r = 0.96,P <.0001)。TAVR术后,通过双猪尾技术得出的平均梯度与使用OpSens OptoWire III得出的平均梯度相似(2.2±3.5对2.8±2.7,P =.16),绝对平均差为1.2±1.3 mmHg,且相关性很强(r = 0.89,P <.0001)。
OpSens OptoWire III导线及其新的TAVR算法得出的血流动力学评估在TAVR前后均与两根猪尾导管测量结果显示出极好的相关性。将这项新技术集成到具有实时血流动力学评估功能的专用TAVR导线上可为TAVR操作人员带来有意义的价值。