Journal article
Impact of valvular resistance on aortic regurgitation after transcatheter aortic valve replacement according to the type of prosthesis.
- Asami M Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Freibrugstrasse, 3010, Bern, Switzerland.
- Pilgrim T Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Freibrugstrasse, 3010, Bern, Switzerland.
- Stortecky S Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Freibrugstrasse, 3010, Bern, Switzerland.
- Heg D Institute of Social and Preventive Medicine and Clinical Trials Unit, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
- Roost E Department of Cardiac Surgery, Swiss Cardiovascular Center, Bern University Hospital, Freibrugstrasse, 3010, Bern, Switzerland.
- Windecker S Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Freibrugstrasse, 3010, Bern, Switzerland.
- Hunziker L Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Freibrugstrasse, 3010, Bern, Switzerland. lukas.hunziker@insel.ch.
- 2019-04-01
Published in:
- Clinical research in cardiology : official journal of the German Cardiac Society. - 2019
Aortic stenosis
Post-procedural aortic regurgitation
Right heart catheterization
Transcatheter aortic valve replacement
Aged
Aged, 80 and over
Aortic Valve
Aortic Valve Insufficiency
Aortic Valve Stenosis
Female
Heart Valve Prosthesis
Hemodynamics
Humans
Male
Prospective Studies
Prosthesis Design
Registries
Risk Assessment
Risk Factors
Transcatheter Aortic Valve Replacement
Treatment Outcome
English
BACKGROUND
The impact of aortic valvular resistance (VR) on the degree of post-transcatheter aortic valve replacement (TAVR) aortic regurgitation (AR) remains unclear. The objective of the study was to investigate the relationship between VR and paravalvular AR after TAVR.
METHODS
Between August 2007 and December 2015, 708 TAVR patients had sufficient data to calculate VR before the intervention and were eligible for the present analysis. The patient population was dichotomized according to VR. The association between VR and post-TAVR AR was separately assessed by prosthesis type.
RESULTS
Among patients with low VR (LVR; < 238 dynes/cm5), 176 (49.7%) patients were treated with balloon-expandable (BE) valves and 178 (51.3%) patients with self-expandable (SE) transcatheter valves. Among patients with high VR (HVR ≥ 238), 147 (41.5%) and 207 (68.5%) patients received BE and SE, respectively. Baseline characteristics were similar in both groups irrespective of the type of valve. Patients with HVR had a 2.5-fold risk of ≥ moderate post-TAVR AR compared to patients with LVR. Both, HVR (HRadj 2.45, 95% CI 1.33-4.51) and the use of SE (HRadj 3.11, 95% CI 1.66-5.82), emerged as independent predictors of ≥ moderate post-TAVR AR. Moderate or greater post-AR was consistently predicted in patients treated with SE (HRadj 2.42, 95% CI 1.22-4.80) irrespective of the level of VR.
CONCLUSIONS
HVR is associated with a nearly 2.5-fold increased risk of moderate or greater post-TAVR AR and is an independent predictor of post-TAVR AR.
The impact of aortic valvular resistance (VR) on the degree of post-transcatheter aortic valve replacement (TAVR) aortic regurgitation (AR) remains unclear. The objective of the study was to investigate the relationship between VR and paravalvular AR after TAVR.
METHODS
Between August 2007 and December 2015, 708 TAVR patients had sufficient data to calculate VR before the intervention and were eligible for the present analysis. The patient population was dichotomized according to VR. The association between VR and post-TAVR AR was separately assessed by prosthesis type.
RESULTS
Among patients with low VR (LVR; < 238 dynes/cm5), 176 (49.7%) patients were treated with balloon-expandable (BE) valves and 178 (51.3%) patients with self-expandable (SE) transcatheter valves. Among patients with high VR (HVR ≥ 238), 147 (41.5%) and 207 (68.5%) patients received BE and SE, respectively. Baseline characteristics were similar in both groups irrespective of the type of valve. Patients with HVR had a 2.5-fold risk of ≥ moderate post-TAVR AR compared to patients with LVR. Both, HVR (HRadj 2.45, 95% CI 1.33-4.51) and the use of SE (HRadj 3.11, 95% CI 1.66-5.82), emerged as independent predictors of ≥ moderate post-TAVR AR. Moderate or greater post-AR was consistently predicted in patients treated with SE (HRadj 2.42, 95% CI 1.22-4.80) irrespective of the level of VR.
CONCLUSIONS
HVR is associated with a nearly 2.5-fold increased risk of moderate or greater post-TAVR AR and is an independent predictor of post-TAVR AR.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1007/s00392-019-01469-z
- PMID 30929034
- Persistent URL
- https://sonar.ch/global/documents/279008
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