Novel predictors of mild paravalvular aortic regurgitation in SAPIEN 3 transcatheter aortic valve implantation.
EuroIntervention
; 14(1): 58-68, 2018 05 20.
Article
em En
| MEDLINE
| ID: mdl-29488887
ABSTRACT
AIMS:
Paravalvular leak (PVL) remains an important issue in TAVI. The Edwards SAPIEN 3 (S3) valve has reduced PVL but in up to one third of patients mild leak remains. Our study aimed to identify predictors of mild PVL after TAVI with the S3 valve. METHODS ANDRESULTS:
From October 2015 to May 2017, 122 consecutive patients underwent S3 TAVI for symptomatic severe aortic stenosis. Thirty-three patients with mild PVL on transthoracic echocardiography at 30-day follow-up were compared to 89 with none/trace PVL. Thirty-day mortality was 2.5% (n=3), with zero stroke and major vascular complications. There were no differences between the two groups in patient characteristics, annular and left ventricular outflow tract (LVOT) sizing, distribution and severity of annular calcification, valve implantation technique, post-dilatation and implant depth. Mild PVL was associated with higher annular eccentricity (p=0.04) and moderate-severe LVOT calcification (p=0.03). Independent predictors of mild PVL were LVOT eccentricity (OR 1.05 per % ellipticity, 95% CI 1.02-1.09, p=0.005), discordant sizing (OR 3.08, 95% CI 1.20-7.90, p=0.02) and three-leaflet calcification (OR 13.3, 95% CI 2.66-66.7, p=0.002).CONCLUSIONS:
LVOT eccentricity and discordant sizing predict PVL after S3 TAVI. Further studies are needed to understand their mechanism and significance.
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Base de dados:
MEDLINE
Assunto principal:
Valva Aórtica
/
Insuficiência da Valva Aórtica
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Estenose da Valva Aórtica
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Substituição da Valva Aórtica Transcateter
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article