Paravalvular leakage (PVL) is a complication of transcatheter aortic valve implantation (TAVI) for aortic stenosis, leading to an adverse prognosis. We investigated whether aortic valve calcium volume (Ca-Vol) measured by preoperative cardiac computed tomography had a predictive value for PVL after TAVI using a third-generation self-expandable valve.

We retrospectively analyzed 59 consecutive patients who underwent TAVI using a third-generation self-expandable valve. We measured Ca-Vol in the aortic valve and each cusp (non-coronary cusp [NCC], right-coronary cusp [RCC], and left-coronary cusp [LCC]). We divided the patients into 2 groups: a PVL group (32.2%) and a non-PVL group (67.8%). Total Ca-Vol was significantly higher in the PVL group than in the non-PVL group (P < 0.001). Ca-Vol in each cusp was also significantly higher in the PVL group ([NCC] P < 0.001, [RCC] P = 0.001, [LCC] P < 0.001). Univariate logistic regression analysis for PVL indicated that the total and per-cusp Ca-Vols were predictors for PVL (total, odds ratio [OR] 4.0, P < 0.001; NCC, OR 12.5, P = 0.002; RCC, OR 16.0, P = 0.008; LCC, OR 44.5, P < 0.001).

Receiver operating characteristic curve analysis of Ca-Vol for predicting PVL revealed the optimal cut-off values of Ca-Vol were 2.4 cm³ for the total, 0.74 cm³ for NCC, 0.73 cm³ for RCC, and 0.56 cm³ for LCC (area under the curve, 0.85, 0.79, 0.76, and 0.83, respectively).

Preoperative total, NCC, RCC, and LCC calcium volumes were significant predictors for PVL after TAVI using third-generation self-expandable valves.

瓣周漏（PVL）是经导管主动脉瓣植入术（TAVI）治疗主动脉瓣狭窄的并发症，导致不良预后。我们研究了术前心脏计算机断层扫描测量的主动脉瓣钙体积 (Ca-Vol) 是否对使用第三代自扩张瓣膜进行 TAVI 后的 PVL 具有预测价值。

我们回顾性分析了 59 名连续接受第三代自扩张瓣膜 TAVI 的患者。我们测量了主动脉瓣和每个尖点（非冠状动脉尖点 [NCC]、右冠状动脉尖点 [RCC] 和左冠状动脉尖点 [LCC]）的 Ca-Vol。我们将患者分为 2 组：PVL 组（32.2%）和非 PVL 组（67.8%）。 PVL 组的总 Ca-Vol 显着高于非 PVL 组 ( P < 0.001)。 PVL 组中每个尖点的 Ca-Vol 也显着较高（[NCC] P < 0.001，[RCC] P = 0.001，[LCC] P < 0.001）。 PVL 的单变量逻辑回归分析表明，总 Ca-Vol 和每尖峰 Ca-Vol 是 PVL 的预测因子（总比值比 [OR] 4.0，P < 0.001；NCC，OR 12.5，P = 0.002；RCC，OR 16.0，P = 0.008；LCC，OR 44.5，P < 0.001）。

用于预测 PVL 的 Ca-Vol 的接受者操作特征曲线分析显示，Ca-Vol 的最佳截止值为总计2.4 cm ³ 、 NCC为 0.74 cm ³ 、 RCC 为0.73 cm ³ 、 LCC 为0.56 cm ³ （曲线下面积分别为 0.85、0.79、0.76 和 0.83）。

术前总钙量、NCC、RCC 和 LCC 钙量是使用第三代自膨胀瓣膜 TAVI 后 PVL 的重要预测因素。