Reclassification from severe to moderate aortic stenosis using hybrid-AVA technique in TAVR patients

Abstract Introduction Echocardiography (echo) may underestimate aortic valve area (AVA) due to the anatomic shape of left ventricular outflow track (LVOT). Using cardiac CT derived LVOT area in the continuity equation (hybrid-AVA) may result in reclassification of patients with severe aortic stenosis (AS) to moderate AS. Aim Our aim was to evaluate the reclassification rate of severe AS to moderate AS by hybrid-AVA, and identify potential predictors of reclassification. Methods We retrospectively analyzed consecutive patients with severe AS (echo-AVA < 1cm2) who underwent transcatheter aortic valve replacement (TAVR) in our tertiary cardiovascular center between 01.01.2020 - 01.09.2024. Hybrid-AVA was calculated by combining CT-based LVOT area and echo Doppler parameters. Patients with hybrid-AVA >1cm2 were reclassified to moderate AS. Patients were divided into two groups: Group 1: aortic mean gradient ≥40 mmHg, Group 2: aortic mean gradient