Automated Cardiac Chamber Volumetry of Pre Trans-Catheter Aortic Valve Replacement CT Angiography Predicts Mortality - The 64th Annual Conference of the Israel Heart Society & The Israel Society of Cardiothoracic Surgery, 25-26 April 2017

Zach Rozenbaum ^1,5 Shlomo Berliner ^2,5 Ariel Finkelstein ^1,5 Dotan Cohen ^3,5 Haim Shmilovich ^1,5 Yan Topilsky ^1,5 Dominik Fleischmann ⁴ Galit Aviram ^3,5

¹Cardiology, Sourasky Medical Center
²Internal Medicine, Sourasky Medical Center
³Radiology, Sourasky Medical Center
⁴Radiology, Stanford Medical Center
⁵Sackler Medical School, Tel Aviv University

Introduction:
We postulated that an automatic four chamber volumetric analysis (4CVA) of cardiac gated computed tomography angiography (CCTA) may contribute to risk stratification of patients undergoing trans-catheter aortic valve implantation (TAVR).

Methods:
Cardiac chambers volumes by CCTA, performed for TAVR planning, were analyzed and compared with echocardiography. Outcomes, including death and heart failure re-admissions, were correlated to chambers’ volumes.

Results:
The study included 173 patients undergoing CCTA before TAVR. A significant correlation was noted between the chambers’ assessment by CCTA volumetry and their measurements by echocardiography, as well as an inverse correlation to ventricular function; Increased right atrial (RA) and RV volumes according to the CCTA were associated with heart failure hospitalization (p=0.03 and p=0.01, respectively) and combined outcomes (p=0.07 and p=0.05, respectively) in a univariate analysis. The addition of the RA volume in nested models eliminated all other CCTA volumetric parameters (p

Conclusions:
We report for the first time that cardiac volumetric data by CCTA performed for procedural planning, may help predict outcome in patients undergoing TAVR.