Prof. Abdulhalim J. Kinsara
View the Slides from this session in ESC Congress 365
Dr. S. Al Ahmari ( Riyadh, Saudi Arabia) explained that aortic root measurement is an important anatomical land mark for determining appropriate treatment for aortic stenosis. 2D Echo is not as accurate at its root as 3D structure. Transoesphageal echo, particularly with 3D, had minimized this error in measurement and TEE showed similar accuracy to cardiac CT, the known standard. Cardiac MRI had showed similar accuracy but it access is limited.
Dr. J. Zamorano Gomez ( Madrid, Spain) believes that fusion imaging is a new, useful modality that combines the data we are getting from echo and fluoroscopy, to optimize aortic valve replacement (AVR).Dr. H. Najm ( Riyadh, Saudi Arabia) explained that aging is associated with many comorbidities, hence surgical AVR is associated with morbidity and mortality due to cross clamp time, ventilation and wound healing. Transcatheter AVR ( TAVI) overcame some of these complications, but created others, such as paravalvular leak ( PVL), complete heart block and coronary obstruction. As such, sutureless AVR developed as alternative that is not only minimally invasive, but also excised the diseased valve, which is expected to decrease PVL, a detrimental morbidity and mortality factor. Three types are available in the market, with encouraging initial data, but require good amount of experience in decalcifying the root and level of implementation.
Dr. M. Monaghan ( London, UK) focused on the Immediate prosthetic PVL which requires a detailed assessment by different echo parameters, like LVOT circumferential colour flow by TEE. 3D TEE gives an even better assessment, but it is often time consuming, and in some cases the intervention might require angiogram or hemodynamic data.
TAVI and sutureless aortic valve replacement: do they compete?, ESC and the Saudi Heart Association
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