Anatomical mapping of the membranous septum in tricuspid and bicuspid aortic valves by cardiac computed tomography

Laurence Campens, Xi Wang, Nicholas J. Montarello, Jingjing He, Klaus Fuglsang Kofoed, Mao Chen, Lars Sondergaard, Ole De Backer*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

A higher incidence of conduction disturbances and permanent pacemaker implantation (PPI) has been observed after transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic valves (BAVs) as compared to those with tricuspid aortic valves (TAVs). This study aimed to provide an anatomical explanation for this observation, supported by an in-depth anatomical mapping of the membranous septum (MS) in a large cohort of BAVs and TAVs using cardiac computed tomography (CT). A total of 300 cardiac CT scans were analysed, revealing a significantly shorter sub-annular length of the MS in BAVs at all measuring points compared to TAVs (p < 0.001). In the current BAV cohort, the MS was found to be at its shortest at the RCC site, measuring less than 1 mm in depth. In addition, the MS was located more anteriorly towards the RCC in BAVs, where the transcatheter aortic valve tends to be implanted deeper, and we observed a trend towards a higher PPI rate in BAVs. Future studies should investigate whether anatomical mapping of the MS in patients undergoing TAVI could be a useful tool for decision-making and potentially mitigate the risk of conduction disturbances.

Original languageEnglish
JournalInternational Journal of Cardiovascular Imaging
Volume39
Issue number8
Pages (from-to)1557-1559
Number of pages3
ISSN1569-5794
DOIs
Publication statusPublished - Aug 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature B.V.

Keywords

  • Aortic valve
  • Bicuspid aortic valve
  • Conduction disturbances
  • Membranous septum
  • Transcatheter aortic valve replacement

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