Usefulness of membranous septum length in the prediction of major conduction disturbances in patients undergoing transcatheter aortic valve replacement with different devices.
Kardiol Pol
; 78(10): 1020-1028, 2020 10 23.
Article
em En
| MEDLINE
| ID: mdl-32735407
ABSTRACT
BACKGROUND:
Conduction disturbances (CD) are one of the most common adverse events after transcatheter aortic valve replacement (TAVR), and seem to be dependent on the device used as well as anatomical factors.AIMS:
The aim of this study was to evaluate whether the length of the membranous septum (MS) could provide useful information about the risk of CD and to examine the impact of the MS on CD after TAVR using different devices.METHODS:
This study included 140 patients undergoing TAVR with a balloonexpandable valve or selfexpanding valve. The length of the MS was assessed by preoperative computed tomography. ΔMSID was calculated as the length of the MS minus implantation depth.RESULTS:
A total of 24 patients (17%) received a permanent pacemaker (PPM), 53 (38%) developed newonset left bundlebranch block (LBBB) following TAVR. The MS length was shown to be the strongest independent predictor of newonset LBBB (odds ratio [OR], 3.05; 95% CI, 1.96-4.77; P <0.001) and PPM implantation (OR, 3.76; 95% CI, 2.01-7.06; P <0.001). ΔMSID was also inversely associated with the development of LBBB and the need for PPM. In a headtohead comparison, ΔMSID values were found to be statistically lower in the selfexpanding valve group (-0.8 mm vs 0.7 mm; P <0.001).CONCLUSIONS:
A short MS and ΔMSID with a negative value increase the risk of CD. Assessment of the MS length prior to TAVR might serve as an additional tool to guide clinical decisionmaking and appropriate device selection to reduce the the risk of CD.
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Base de dados:
MEDLINE
Assunto principal:
Substituição da Valva Aórtica Transcateter
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article