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Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis.
Bugani, Giulia; Pagnesi, Matteo; Tchetchè, Didier; Kim, Won- Keun; Khokhar, Arif; Sinning, Jean- Malte; Landes, Uri; Kornowski, Ran; Codner, Pablo; De Backer, Ole; Nickenig, Georg; Ielasi, Alfonso; De Biase, Chiara; Søndergaard, Lars; De Marco, Federico; Ancona, Marco; Montorfano, Matteo; Regazzoli, Damiano; Stefanini, Giulio; Toggweiler, Stefan; Tamburino, Corrado; Immè, Sebastiano; Tarantini, Giuseppe; Sievert, Horst; Schäfer, Ulrich; Kempfert, Jörg; Wöehrle, Jochen; Tespili, Maurizio; Laricchia, Alessandra; Latib, Azeem; Giannini, Francesco; Colombo, Antonio; Mangieri, Antonio.
Afiliação
  • Bugani G; Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy.
  • Pagnesi M; San Raffaele Scientific Institute, Milan, Italy.
  • Tchetchè D; Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France.
  • Kim WK; Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany.
  • Khokhar A; Interventional Cardiology Unit, GVM Care and Research, Maria Cecilia Hospital, via della Corriera 1, 48033, Cotignola, Ravenna, Italy.
  • Sinning JM; Cardiology Department, University Hospital Bonn, Bonn, Germany.
  • Landes U; Cardiology Department, Rabin Medical Center, Petah Tikva, Israel.
  • Kornowski R; Cardiology Department, Rabin Medical Center, Petah Tikva, Israel.
  • Codner P; Cardiology Department, Rabin Medical Center, Petah Tikva, Israel.
  • De Backer O; The Heart Center-Rigshospitalet, Copenhagen, Denmark.
  • Nickenig G; Cardiology Department, University Hospital Bonn, Bonn, Germany.
  • Ielasi A; Istituto Clinico Sant'Ambrogio, Milan, Italy.
  • De Biase C; Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France.
  • Søndergaard L; The Heart Center-Rigshospitalet, Copenhagen, Denmark.
  • De Marco F; Department of Cardiology, IRCCS Policlinico San Donato, Milan, Italy.
  • Ancona M; San Raffaele Scientific Institute, Milan, Italy.
  • Montorfano M; San Raffaele Scientific Institute, Milan, Italy.
  • Regazzoli D; Clinical and Interventional Cardiology Unit, Cardio Center, Humanitas Research Hospital, Rozzano, Milan, Italy.
  • Stefanini G; Clinical and Interventional Cardiology Unit, Cardio Center, Humanitas Research Hospital, Rozzano, Milan, Italy.
  • Toggweiler S; Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland.
  • Tamburino C; Cardiology Division, CAST Policlinico Hospital, University of Catania, Catania, Italy.
  • Immè S; Centro Cuore Morgagni, Catania, Italy.
  • Tarantini G; Interventional Cardiology Unit, University of Padova, Padua, Italy.
  • Sievert H; Cardiovascular Center Frankfurt, Frankfurt, Germany.
  • Schäfer U; Anglia Ruskin University, Chelmsford, UK.
  • Kempfert J; UKE Hamburg, Hamburg, Germany.
  • Wöehrle J; Deutsches Herzzentrum Berlin, Charité Universitätsmedizin, Berlin, Germany.
  • Tespili M; Ulm University, Ulm, Germany.
  • Laricchia A; Istituto Clinico Sant'Ambrogio, Milan, Italy.
  • Latib A; Interventional Cardiology Unit, GVM Care and Research, Maria Cecilia Hospital, via della Corriera 1, 48033, Cotignola, Ravenna, Italy.
  • Giannini F; Department of Cardiology, Montefiore Medical Center, New York, NY, USA.
  • Colombo A; Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
  • Mangieri A; Interventional Cardiology Unit, GVM Care and Research, Maria Cecilia Hospital, via della Corriera 1, 48033, Cotignola, Ravenna, Italy.
Clin Res Cardiol ; 110(5): 667-675, 2021 May.
Article em En | MEDLINE | ID: mdl-33389062
ABSTRACT

OBJECTIVES:

To define the incidence of high residual gradient (HRG) after transcatheter aortic valve replacement (TAVR) in BAVs and their impact on short term outcome and 1-year mortality.

BACKGROUND:

Transcatheter heart valves (THVs) offer good performance in tricuspid aortic valves with low rate of HRG. However, data regarding their performance in bicuspid aortic valves (BAV) are still lacking.

METHODS:

The BEAT (Balloon vs Self-Expandable valve for the treatment of bicuspid Aortic valve sTenosis) registry included 353 consecutive patients who underwent TAVR (Evolut R/PRO or Sapien 3 valves) in BAV between June 2013 and October 2018. The primary endpoint was device unsuccess with post-procedural HRG (mean gradient ≥ 20 mmHg). The secondary endpoint was to identify the predictors of HRG following the procedure.

RESULTS:

Twenty patients (5.6%) showed HRG after TAVR. Patients with HRG presented higher body mass index (BMI) (30.7 ± 9.3 vs. 25.9 ± 4.8; p < 0.0001) and higher baseline aortic mean gradients (57.6 ± 13.4 mmHg vs. 47.7 ± 16.6, p = 0.013) and more often presented with BAV of Sievers type 0 than patients without HRG. At multivariate analysis, BMI [odds ratio (OR) 1.12; 95% confidence interval (CI) 1.05-1.20, p = 0.001] and BAV type 0 (OR 11.31, 95% CI 3.45-37.06, p < 0.0001) were confirmed as independent predictors of high gradient.

CONCLUSION:

HRG following TAVR in BAVs is not negligible and is higher among patients with high BMI and with BAV 0 anatomy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estenose da Valva Aórtica / Substituição da Valva Aórtica Transcateter / Doença da Válvula Aórtica Bicúspide Tipo de estudo: Incidence_studies / Observational_studies / Prognostic_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Clin Res Cardiol Assunto da revista: CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Itália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estenose da Valva Aórtica / Substituição da Valva Aórtica Transcateter / Doença da Válvula Aórtica Bicúspide Tipo de estudo: Incidence_studies / Observational_studies / Prognostic_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Clin Res Cardiol Assunto da revista: CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Itália