Investigation of computed-tomography based predictors of acute stroke related to transcatheter aortic valve replacement: Aortic wall plaque thickness might be a predictive parameter of stroke

Masaki Miyasaka, Rahul P. Sharma, Yoshio Maeno, Masataka Taguri, Sung Han Yoon, Hiroyuki Kawamori, Norio Tada, Shigeaki Kato, Sharjeel Israr, Takahiro Nomura, Tomoki Ochiai, Yigal Abramowitz, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, John D. Friedman, Daniel S. Berman, Raj R. Makkar

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives. Little information is available on computed tomography (CT)-based predictors of stroke related to transcatheter aortic valve replacement (TAVR). The objective of this study was to determine whether anatomical features of the aortic valve and aorta visualized by CT are predictive parameters of stroke. Methods. The study included 1270 patients who underwent preprocedural contrast-enhanced CT assessment and TAVR for severe aortic valve stenosis. Twenty-six patients (2.5%) who developed acute strokes that occurred within 48 hours after TAVR and 104 matched patients without strokes were identified, using 1:4 propensity-score matching. The degree of hypoattenuation in the aortic valve leaflets, calcium volume of the aortic valve, and plaque thickness in the aortic wall (the ascending aorta, aortic arch, and descending thoracic aorta) were assessed. Results. There were no differences between the two groups in the degree of hypoattenuation in the aortic valve leaflets and calcium volume of the aortic valve. The plaque thickness of the aortic arch and descending aorta were greater in the stroke group than in the non-stroke group: aortic arch, 2.4 mm (IQR, 1.3-2.8 mm) vs 1.8 mm (IQR, 1.4-2.2 mm), respectively (P<.01); and descending aorta, 2.9 mm (IQR, 2.1-4.2 mm) vs 2.8 mm (IQR, 2.1-3.6 mm); respectively (P=.049). Conclusion. Aortic wall plaque thickness measured by contrast-enhanced CT might be a predictive parameter of strokes that occur within 48 hours after TAVR.

Original languageEnglish
Pages (from-to)E18-E26
JournalJournal of Invasive Cardiology
Volume33
Issue number2
StatePublished - 1 Jan 2020
Externally publishedYes

Keywords

  • Aortic stenosis
  • Computed tomography
  • Plaque
  • Stroke

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