Late gadolinium enhancement as a potential marker of increased perioperative risk in aortic valve replacement

Cesare Quarto*, Marc R. Dweck, Timothy Murigu, Sanjiv Joshi, Giovanni Melina, Emiliano Angeloni, Sanjay K. Prasad, John R. Pepper

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: Risk assessment of patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR) is challenging. We set out to determine the impact of myocardial late gadolinium enhancement (LGE), as detected by cardiovascular magnetic resonance (CMR), on postoperative outcomes following AVR.

METHODS: A prospective observational study was conducted on patients undergoing CMR using the LGE technique within 1 year of subsequent AVR. Patients were categorized into absent, mid-wall or infarct patterns of LGE by independent observers blinded to all clinical data, and data were collected with regard to 30-day mortality, major adverse cardiac and cerebrovascular events (MACCE) and postoperative complications.

RESULTS: A total of 63 patients were studied. Twenty-five patients had no LGE; 20 had mid-wall LGE and 18 had an infarct pattern. The incidence of MACCE, cerebrovascular accident (CVA) and heart block were significantly higher in the mid-wall group compared with the other two groups (MACCE: 25 vs. 0 vs. 5%, P = 0.014; CVA: 20 vs. 0 vs. 0%, P = 0.013; heart block: 30 vs. 4 vs. 12%, P = 0.050). Patients with no LGE had no 30-day MACCE events and no deaths up to 2 years of follow-up.

CONCLUSIONS: The myocardial LGE holds promise as a means of predicting risk prior to AVR for AS.

Original languageEnglish
Pages (from-to)45-50
Number of pages6
JournalInteractive cardiovascular and thoracic surgery
Volume15
Issue number1
DOIs
Publication statusPublished - Jul 2012
Event25th Annual Meeting of the European-Association-for-Cardio-Thoracic-Surgery (EACTS) - Lisbon, Portugal
Duration: 1 Oct 20115 Oct 2011

Keywords

  • Risk assessment
  • CARDIOMYOPATHY
  • Myocardial fibrosis
  • PREDICTOR
  • Magnetic resonance
  • MORTALITY
  • MIDWALL FIBROSIS
  • Aortic valve stenosis
  • CARDIAC MAGNETIC-RESONANCE
  • STENOSIS
  • LEFT-VENTRICULAR HYPERTROPHY

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