A novel synchronised diastolic injection method to reduce contrast volume during aortography for aortic regurgitation assessment: in vitro experiment of a transcatheter heart valve model

Yosuke Miyazaki, Mohammad Abdelghani, Ellen S. de Boer, Jean-Paul Aben, Math van Sloun, Todd Suchecki, Marcel van 'tVeer, Carlos Collet, Taku Asano, Yuki Katagiri, Erhan Tenekecioglu, Osama I. I. Soliman, Yoshinobu Onuma, Robbert de Winter, Pim Tonino, Frans N. van de Vosse, Marcel C. M. Rutten, Patrick W. Serruys*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Aims: In the minimalist transcatheter aortic valve implantation (TAVI) era, the usage of transoesophageal echocardiography has become restricted. Conversely, aortography has gained clinical ground in quantifying prosthetic valve regurgitation (PVR) during the procedure. In a mock circulation system, we sought to compare the contrast volume required and the accuracy of aortographic videodensitometric PVR assessment using a synchronised diastolic and standard (non-synchronised) injection aortography.

Methods and results: Synchronised diastolic injection triggered by the signal stemming from the mock circulation was compared with standard non-synchronised injection. A transcatheter heart valve was implanted and was deformed step by step by advancing a screw perpendicularly to the cage of the valve in order to create increasing PVR. Quantitative measurement of PVR was derived from time-density curves of both a reference area (aortic root) and a region of interest (left ventricle) developed by a videodensitometric software. The volume of contrast required for the synchronised diastolic injection was significantly less than in the non-synchronised injection (8.1 [7.9-8.5] ml vs. 19.4 [19.2-19.9] ml, p

Conclusions: A short synchronised diastolic injection enables contrast volume reduction during aortography without compromising the accuracy of the quantitative assessment of PVR using videodensitometry.

Original languageEnglish
Pages (from-to)1289-1296
Number of pages8
Issue number11
Publication statusPublished - Dec 2017


  • aortic stenosis
  • paravalvular leak
  • transcatheter aortic valve implantation (TAVI)
  • TAVI

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