Impact of valvular resistance on aortic regurgitation after transcatheter aortic valve replacement according to the type of prosthesis.

Asami, Masahiko; Pilgrim, Thomas; Stortecky, Stefan; Heg, Dik; Roost, Eva; Windecker, Stephan; Hunziker, Lukas (2019). Impact of valvular resistance on aortic regurgitation after transcatheter aortic valve replacement according to the type of prosthesis. (In Press). Clinical research in cardiology Springer-Verlag 10.1007/s00392-019-01469-z

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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/cm), 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 (HR 2.45, 95% CI 1.33-4.51) and the use of SE (HR 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 (HR 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Asami, Masahiko; Pilgrim, Thomas; Stortecky, Stefan; Heg, Dierik Hans; Roost, Eva; Windecker, Stephan and Hunziker, Lukas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1861-0684

Publisher:

Springer-Verlag

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

02 Apr 2019 12:30

Last Modified:

04 Jul 2019 15:18

Publisher DOI:

10.1007/s00392-019-01469-z

PubMed ID:

30929034

Uncontrolled Keywords:

Aortic stenosis Post-procedural aortic regurgitation Right heart catheterization Transcatheter aortic valve replacement

BORIS DOI:

10.7892/boris.129836

URI:

https://boris.unibe.ch/id/eprint/129836

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