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
in 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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aortic Valve
/
Aortic Valve Stenosis
/
Calcinosis
/
Catheterization, Peripheral
/
Femoral Artery
/
Balloon Valvuloplasty
/
Transcatheter Aortic Valve Replacement
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
En
Journal:
Catheter Cardiovasc Interv
Journal subject:
CARDIOLOGIA
Year:
2019
Document type:
Article
Affiliation country:
Germany