Insights into new-onset rhythm conduction disorders detected by multi-detector row computed tomography after transcatheter aortic valve implantation.
Am J Cardiol
; 114(10): 1556-61, 2014 Nov 15.
Article
en En
| MEDLINE
| ID: mdl-25245414
ABSTRACT
New-onset rhythm conduction disorders are frequent after transcatheter aortic valve implantation (TAVI). Multidetector row computed tomography may shed light on the pathophysiology of rhythm conduction disorders in patients who undergo TAVI with the Edwards SAPIEN valve. A total of 94 patients (mean age 81 ± 7 years, 48% men) treated with TAVI with the Edwards SAPIEN valve who underwent pre- and post-TAVI multidetector row computed tomography were included. Patients with preexisting right bundle branch block or left bundle branch block (LBBB) and permanent pacemakers were excluded. Pacemaker implantation or new-onset LBBB at 1-month follow-up was the combined end point. Overall, 1 pacemaker was implanted, and 14 cases of new-onset LBBB were recorded. Among several clinical and multi-detector row computed tomographic variables, overexpansion of the transcatheter valve >15% of native annular area (odds ratio 5.277, 95% confidence interval 1.398 to 19.919, p = 0.014) and depth of frame into the left ventricular outflow tract (odds ratio 1.401, 95% confidence interval 1.066 to 1.770, p = 0.010) were independently related to the need for a pacemaker or new-onset LBBB. In conclusion, overexpansion of the transcatheter prosthesis by >15% of native aortic annular area and implantation depth of the frame into the left ventricular outflow tract were independently associated with the need for a pacemaker or new-onset LBBB in patients who underwent TAVI with the Edwards SAPIEN valve.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Estenosis de la Válvula Aórtica
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Arritmias Cardíacas
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Complicaciones Posoperatorias
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Prótesis Valvulares Cardíacas
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Electrocardiografía
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Tomografía Computarizada Multidetector
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Reemplazo de la Válvula Aórtica Transcatéter
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Sistema de Conducción Cardíaco
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
Am J Cardiol
Año:
2014
Tipo del documento:
Article
País de afiliación:
Países Bajos