Impact of severe left ventricular outflow tract calcification on device failure and short-term mortality in patients undergoing TAVI.
J Cardiovasc Comput Tomogr
; 14(1): 36-41, 2020.
Article
en En
| MEDLINE
| ID: mdl-31327744
BACKGROUND: To investigate the impact of left ventricular outflow tract (LVOT) calcification on the incidence of device failure and mortality in patients undergoing transcatheter aortic valve implantation (TAVI). METHODS: Of 690 consecutive patients undergoing transfemoral TAVI in our center from January 2013 to December 2015, 600 presented with non-severe (NSCALVOT) and 90 (13.0%) with severe (SCALVOT) LVOT calcification. Primary outcome of interest was device failure defined as a composite of procedural death, prosthesis dislocation, annulus rupture or significant para-valvular leakage (PVL). Secondary outcome of interest was 30-day and one-year all-cause mortality. RESULTS: Mean age of the population was 80.8⯱â¯7.2 years, mean STS score was 5.7⯱â¯4.6% and 50.6% of the patients were women. Patients with SCALVOT more frequently experienced device failure (10.0% vs. 3.8%, pâ¯=â¯0.009) and were at higher risk of 30 day (10.0% vs. 2.8%, pâ¯<â¯0.001) all cause mortality as compared to those with NSCALVOT. Furthermore, patients with SCALVOT were more frequently in need of post-dilation (15.6% vs. 8.5%, pâ¯=â¯0.032) and showed higher incidence of significant PVL (7.8% vs. 2.5%, pâ¯=â¯0.007). In multivariate analysis, SCALVOT (hazard ratio 2.87; 95% CI 1.20 to 6.34) and use of balloon-expandable prosthesis (hazard ratio 0.32; 95% CI 0.15 to 0.73) were identified as independent predictors of device failure. CONCLUSION: Presence of severe LVOT calcification in patients undergoing transfemoral TAVI is associated with a higher risk of device failure and short-term mortality.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Válvula Aórtica
/
Estenosis de la Válvula Aórtica
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Falla de Prótesis
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Calcinosis
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Prótesis Valvulares Cardíacas
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Función Ventricular Izquierda
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Reemplazo de la Válvula Aórtica Transcatéter
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Cardiovasc Comput Tomogr
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
RADIOLOGIA
Año:
2020
Tipo del documento:
Article
Pais de publicación:
Estados Unidos