Generic Portal

TY - JOUR

T1 - Four-dimensional flow MRI of stented versus stentless aortic valve bioprostheses

AU - van Kesteren, Floortje

AU - Wollersheim, Laurens W.

AU - Baan, Jan

AU - Nederveen, Aart J.

AU - Kaya, Abdullah

AU - Boekholdt, S. Matthijs

AU - de Mol, Bas A.

AU - van Ooij, Pim

AU - Planken, R. Nils

PY - 2018

Y1 - 2018

N2 - To evaluate aortic velocity, wall shear stress (WSS) and viscous energy loss (EL) of stented and stentless bioprostheses using 4D flow MRI 1 year after surgical aortic valve replacement. For this cross-sectional study 28 patients with stented (n = 14) or stentless (n = 14) bioprosthesis underwent non-contrast-enhanced 4D-flow MRI at 1.5 T. Analyses included a comparison of velocity, WSS and EL in the ascending aorta during peak systole for both spatially averaged values and a comparison of local differences using per-voxel analysis. No significant differences were found in peak and mean velocity (stented vs. stentless: 2.45 m/s vs. 2.11 m/s; p = 0.09 and 0.60 m/s vs. 0.62 m/s; p = 0.89), WSS (0.60 Pa vs. 0.59 Pa; p = 0.55) and EL (10.17 mW vs. 7.82 mW; p = 0.10). Per-voxel analysis revealed significantly higher central lumen velocity, and lower outer lumen velocity, WSS and EL for stentless versus stented prostheses. One year after aortic valve implantation with stented and stentless bioprostheses, velocity, WSS and EL were comparable when assessed for averaged values in the ascending aorta. However, the flow profile described with local analysis for stentless prosthesis is potentially favourable with a significantly higher central velocity profile and lower values for outer lumen velocity, WSS and EL. aEuro cent Stentless bioprostheses can be implanted instead of stented aortic valve bioprostheses. aEuro cent Haemodynamic performance of valve prosthesis can be assessed using 4D flow MRI. aEuro cent Averaged ascending aorta PSV, WSS and EL are comparable 1 year post-implantation. aEuro cent Centreline velocity is highest, WSS and EL is lowest for stentless prosthesis

AB - To evaluate aortic velocity, wall shear stress (WSS) and viscous energy loss (EL) of stented and stentless bioprostheses using 4D flow MRI 1 year after surgical aortic valve replacement. For this cross-sectional study 28 patients with stented (n = 14) or stentless (n = 14) bioprosthesis underwent non-contrast-enhanced 4D-flow MRI at 1.5 T. Analyses included a comparison of velocity, WSS and EL in the ascending aorta during peak systole for both spatially averaged values and a comparison of local differences using per-voxel analysis. No significant differences were found in peak and mean velocity (stented vs. stentless: 2.45 m/s vs. 2.11 m/s; p = 0.09 and 0.60 m/s vs. 0.62 m/s; p = 0.89), WSS (0.60 Pa vs. 0.59 Pa; p = 0.55) and EL (10.17 mW vs. 7.82 mW; p = 0.10). Per-voxel analysis revealed significantly higher central lumen velocity, and lower outer lumen velocity, WSS and EL for stentless versus stented prostheses. One year after aortic valve implantation with stented and stentless bioprostheses, velocity, WSS and EL were comparable when assessed for averaged values in the ascending aorta. However, the flow profile described with local analysis for stentless prosthesis is potentially favourable with a significantly higher central velocity profile and lower values for outer lumen velocity, WSS and EL. aEuro cent Stentless bioprostheses can be implanted instead of stented aortic valve bioprostheses. aEuro cent Haemodynamic performance of valve prosthesis can be assessed using 4D flow MRI. aEuro cent Averaged ascending aorta PSV, WSS and EL are comparable 1 year post-implantation. aEuro cent Centreline velocity is highest, WSS and EL is lowest for stentless prosthesis

U2 - 10.1007/s00330-017-4953-2

DO - 10.1007/s00330-017-4953-2

M3 - Article

C2 - 28710578

VL - 28

SP - 257

EP - 264

JO - European radiology

JF - European radiology

SN - 0938-7994

IS - 1

ER -