Process Monitor 3.95 for mac download1/14/2024 MAC was qualitatively and quantitatively assessed by 2 observers (K.H and A.R.P). Data processing was performed using offline CT workstations (3mensio version 10.2, Pie Medical Imaging, Bilthoven, the Netherlands Vitrea 2, Vital Images, Plymouth, MN, USA). In contrast, with a 320-detector scanner, the entire cardiac cycle was scanned using prospective ECG triggered dose modulation. With a 64-detector scanner, data acquisition was performed gated to the ECG to facilitate retrospective gating. Ĭardiac CT data were acquired prior to TAVI using a 64-row (Aquilion64, Toshiba Medical Systems, Otawara, Japan) or a 320-row CT scanner (AquilionOne, Toshiba Medical Systems, Tochigi-ken, Japan). Furthermore, studies which have examined changes in these hemodynamic indices have compared pre- with early post-procedural echocardiography, a time susceptible to temporary hemodynamic derangements due to procedural complications and the use of inotropes, with delays in the recovery of normal loading conditions. For instance, it is unclear whether the mean TMG increases or decreases following the procedure, or whether there will be a reduction or improvement in the hemodynamic impact of mitral valve stenosis. However, alterations in valvular hemodynamics following TAVI that are associated with mitral stenosis remain poorly understood. Indeed, changes in mitral regurgitation following TAVI for severe aortic stenosis (AS) have been well-described, with studies describing a reduction in regurgitation severity in 50–70% of patients. Predicting alterations to the hemodynamic significance of concomitant mitral valve lesions following TAVI may inform clinical decision-making and provide an insight into underlying valvular pathophysiology. Multiple valve disease is frequently observed in patients undergoing transcatheter aortic valve implantation (TAVI), with significant mitral stenosis (defined as a mean transmitral pressure gradient ≥ 5 mm Hg) discernible in approximately 10% of patients.
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