Degree of valve calcification in patients undergoing transfemoral transcatheter aortic valve implantation with and without balloon aortic valvuloplasty: Findings from the multicenter EASE-IT TF registry.
Catheter Cardiovasc Interv
; 94(3): 469-478, 2019 Sep 01.
Article
en En
| MEDLINE
| ID: mdl-30866154
ABSTRACT
AIMS:
We aimed to assess whether the level of aortic root calcification is associated with BAV performance/omission during transcatheter aortic valve implantation (TAVI), and to explore related outcomes. METHODS ANDRESULTS:
EASE-IT TF was a prospective, observational, multicenter registry of patients undergoing TF-TAVI with the Edwards SAPIEN 3, with or without BAV predilation. Valvular calcification was quantified from pre-procedural multi-slice computed tomography images and compared between BAV and no BAV patients. Data for 178 patients (55 BAV; 123 no BAV) were analyzed. There were no significant differences between groups in terms of regional/leaflet sector calcification volumes, maximum asymmetry between the different leaflet sectors, or total calcification scores. Overall, a greater-than-average leaflet calcification volume was independently predictive of ≥mild PVL (OR 5.116; 95% CI 1.042-38.35) and the need for post-dilation (OR 3.592; 95% CI 1.173-12.14). The latter effect was abated in patients with BAV (OR 1.837; 95% CI 0.223-18.00) and intensified in those without BAV (OR 5.575; 95% CI 1.114-38.74). No other BAV-dependent effects of calcification on outcomes were observed.CONCLUSIONS:
In the majority of transfemoral valve implantations, calcification does not appear to be the main driving factor in the decision to perform/omit BAV. Predilation may be valuable for reducing post-dilation requirements in patients only with a greater degree of leaflet calcification.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Válvula Aórtica
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Estenosis de la Válvula Aórtica
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Calcinosis
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Cateterismo Periférico
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Arteria Femoral
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Valvuloplastia con Balón
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Reemplazo de la Válvula Aórtica Transcatéter
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Año:
2019
Tipo del documento:
Article