Assessment of Retinal Capillary Dropout after Transcatheter Aortic Valve Implantation by Optical Coherence Tomography Angiography

Transcatheter aortic valve implantation (TAVI) is an alternative to open heart surgery in the treatment of symptomatic aortic valve stenosis, which is often the treatment of choice in elderly and frail patients. It carries a risk of embolic complications in the whole cerebral vascular bed, which inc...

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Published in:Diagnostics (Basel) 2021-12, Vol.11 (12), p.2399
Main Authors: Gunzinger, Jeanne Martine, Ibrahimi, Burbuqe, Baur, Joel, Wiest, Maximilian Robert Justus, Piccirelli, Marco, Pangalu, Athina, Straumann, Dominik, Nietlispach, Fabian, Moarof, Igal, Zweifel, Sandrine Anne
Format: Article
Language:English
Subjects:
Algorithms
Angiography
Aortic stenosis
Aortic valve stenosis
Care and treatment
Demographics
Diabetes
Diabetic retinopathy
Diagnosis
Hypertension
Macular degeneration
Magnetic resonance imaging
Medical imaging
Medical research
Medicine, Experimental
OCTA
optical coherence tomography angiography
Patients
Quantitative analysis
retinal emboli
Stroke
TAVI
Tomography
transcatheter aortic valve implantation
Values
Veins & arteries
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Summary:Transcatheter aortic valve implantation (TAVI) is an alternative to open heart surgery in the treatment of symptomatic aortic valve stenosis, which is often the treatment of choice in elderly and frail patients. It carries a risk of embolic complications in the whole cerebral vascular bed, which includes the retinal vasculature. The main objective was the evaluation of retinal emboli visible on optical coherence tomography angiography (OCTA) following TAVI. This is a prospective, single center, observational study enrolling consecutive patients over two years. Patients were assessed pre- and post-TAVI. Twenty-eight patients were included in the final analysis, 82.1% were male, median age was 79.5 (range 52-88), median BCVA was 82.5 letters (range 75-93). Eight patients (28.6%) presented new capillary dropout lesions in their post-TAVI OCTA scans. There was no statistically significant change in BCVA. Quantitative analysis of macular or peripapillary OCTA parameters did not show any statistically significant difference in pre- and post-intervention. In conclusion, capillary dropout lesions could frequently be found in patients after TAVI. Quantitative measurements of macular and peripapillary flow remained stable, possibly indicating effective ocular blood flow regulation within the range of left ventricular ejection fraction in our cohort.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics11122399