Short membranous septum length in bicuspid aortic valve stenosis increases the risk of conduction disturbances.
J Cardiovasc Comput Tomogr
; 15(4): 339-347, 2021.
Article
em En
| MEDLINE
| ID: mdl-33153946
ABSTRACT
BACKGROUND:
Distinct anatomical features predispose bicuspid AS patients to conduction disturbances after TAVR. This study sought to evaluate whether the incidence of permanent pacemaker implantation (PPMI) and left bundle branch block (LBBB) in patients with bicuspid aortic stenosis (AS) following transcatheter aortic valve replacement (TAVR) is related to an anatomical association between bicuspid AS and short membranous septal (MS) length.METHODS:
Sixty-seven consecutive patients with bicuspid AS from a Bicuspid AS TAVR multicenter registry and 67 propensity-matched patients with tricuspid AS underwent computed tomography before TAVR.RESULTS:
MS length was significantly shorter in bicuspid AS compared with tricuspid AS (6.2 ± 2.5 mm vs. 8.4 ± 2.7 mm, respectively; p < 0.001). In patients with bicuspid AS, MS length and aortic valve calcification were the most powerful pre-procedural independent predictors of PPMI or LBBB (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.15 to 1.55, p = 0.003 and OR 1.92, 95% CI 1.1 to 3.34, p = 0.022, respectively). When taking into account pre- and post-procedural parameters, aortic valve calcification and the difference between MS length and implantation depth were the most powerful independent predictors of PPMI or LBBB in patients with bicuspid AS (OR 1.82, 95% 1.1 to 3.1, p = 0.027; OR 1.25, 95% CI 1.10 to 1.38, p = 0.003).CONCLUSION:
MS length, which was significantly shorter in bicuspid AS compared with tricuspid AS, aortic valve calcification, and device implantation deeper than MS length predict PPMI or LBBB in bicuspid AS after TAVR.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
/
Marca-Passo Artificial
/
Próteses Valvulares Cardíacas
/
Substituição da Valva Aórtica Transcateter
/
Doença da Válvula Aórtica Bicúspide
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article