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Elkoumy A, Jose J, Gunasekaran S, Kumar A, Srinivas BC, Manjunath CN, Ravindranath KS, Parekh M, Chandra P, Kapoor R, Abdelshafy M, Seth A, Agrawal P, Mathur A, Rao RS, Elzomor H, Sadanada KS, Kumar V, Arsang-Jang S, Mehrotra S, Raghuraman B, Khanolkar U, Premchand RK, Chopra M, Krishna P, Mehta H, Gupta R, Kumar V, Boopathy N, Baumbach A, Serruys PW, Soliman O. Angiographic quantification of aortic regurgitation following myval octacor implantation; independent core lab adjudication. Int J Cardiol 2023; 382:68-75. [PMID: 37028710 DOI: 10.1016/j.ijcard.2023.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND The balloon expandable Myval transcatheter heart valve (THV) showed encouraging results regarding residual aortic regurgitation (AR) from multiple observational studies. The newly designed Myval Octacor has been introduced recently, aiming for a reduction in AR and improved performance. OBJECTIVES The focus of this study is to report the incidence of AR using the validated quantitative Videodensitometry angiography technology (qLVOT-AR%) in the first in human use of the Myval Octacor THV system. METHODOLOGY We report on the first in human use of the Myval Octacor THV system in 125 patients in 18 Indian centres. Independent retrospective analysis of the final aortograms following implantation of the Myval Octacor was performed using the CAAS-A-Valve software. AR is reported as a regurgitation fraction. The previously validated cutoff values have been used to identify ≥moderate AR (RF% >17%), mild (6% < RF% ≤17%), and none or trace AR (RF% ≤ 6%). RESULTS Final aortogram was analysable for 103 patients (84.4%) among the 122 available aortograms. 64 (62%) patients, had tricuspid aortic valve (TAV), 38 (37%) with bicuspid AV (BAV), and one with unicuspid AV. The median absolute RF% was 2% [1, 6], moderate or more AR incidence was 1.9%, mild AR in 20.4%, and none or trace AR in 77.7%. The two cases with RF% >17% were in the BAV group. CONCLUSION The initial results of Myval Octacor using quantitative angiography-derived regurgitation fraction demonstrated a favourable outcome regarding residual AR, possibly due to improved device design. Results must be confirmed in a larger randomised study, including other imaging modalities.
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Affiliation(s)
- Ahmed Elkoumy
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland; Islamic Center of Cardiology, Al-Azhar University, Nasr City, Cairo 11651, Egypt
| | - John Jose
- Department of Cardiology, Christian Medical College & Hospital, Vellore 632004, India
| | | | - Asish Kumar
- Department of Cardiology, Meitra Hospital, Calicut, Kerala 673005, India
| | - B C Srinivas
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru 560041, India
| | - C N Manjunath
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru 560041, India
| | - K S Ravindranath
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru 560041, India
| | - Maulik Parekh
- Sir H. N. Reliance Foundation Hospital and Research Centre, Girgaon, Mumbai, Maharashtra 400004, India
| | | | | | - Mahmoud Abdelshafy
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland
| | - Ashok Seth
- Fortis Escorts Heart Institute, New Delhi 110025, India
| | | | - Atul Mathur
- Fortis Escorts Heart Institute, New Delhi 110025, India
| | | | - Hesham Elzomor
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland
| | - K S Sadanada
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysuru, Karnataka 570016, India
| | - Vijay Kumar
- Madras Medical Mission Hospital, Chennai, Tamil Nadu 600037, India
| | - Shahram Arsang-Jang
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland; CÚRAM, SFI Research Centre for Medical Devices, H91 W2TY Galway, Ireland
| | - Sanjay Mehrotra
- Narayana Institute of Cardiac Sciences, Bengaluru, Karnataka 560099, India
| | | | - Uday Khanolkar
- Narayana Institute of Cardiac Sciences, Bengaluru, Karnataka 560099, India
| | | | - Manik Chopra
- Narayana Hospital (NH), Ahmedabad, Gujarat 380023, India
| | - Prem Krishna
- P S Govindaswami (PSG), Coimbatore 641004, India
| | - Haresh Mehta
- S. L. Raheja Hospital - Fortis, Mumbai, Maharashtra 400016, India
| | - Rahul Gupta
- Apollo Hospital, Navi Mumbai, Maharashtra 400614, India
| | - Viveka Kumar
- Max Hospital, Saket, New Delhi, Delhi 110017, India
| | | | - Andreas Baumbach
- William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London EC1M 6BQ, UK
| | - Patrick W Serruys
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland; CÚRAM, SFI Research Centre for Medical Devices, H91 W2TY Galway, Ireland
| | - Osama Soliman
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland; CÚRAM, SFI Research Centre for Medical Devices, H91 W2TY Galway, Ireland.
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