CBS 2019
CBSMD教育中心
English

Transcatheter Aortic Valve Replacement

科研文章

荐读文献

Impact of Incomplete Coronary Revascularization on Late Ischemic and Bleeding Events after Transcatheter Aortic Valve Replacement Extracellular Myocardial Volume in Patients With Aortic Stenosis Safety and Efficacy of Transcatheter Aortic Valve Replacement With Continuation of Vitamin K Antagonists or Direct Oral Anticoagulants Edoxaban versus Dual Antiplatelet Therapy for Leaflet Thrombosis and Cerebral Thromboembolism after TAVR: The ADAPT-TAVR Randomized Clinical Trial Comparison of 1-Year Pre- And Post-Transcatheter Aortic Valve Replacement Hospitalization Rates: A Population-Based Cohort Study Infective endocarditis after transcatheter aortic valve implantation: a nationwide study Rationale and design of a randomized clinical trial comparing safety and efficacy of Myval transcatheter heart valve versus contemporary transcatheter heart valves in patients with severe symptomatic aortic valve stenosis: the LANDMARK trial Thrombotic Versus Bleeding Risk After Transcatheter Aortic Valve Replacement: JACC Review Topic of the Week Ambulatory Electrocardiogram Monitoring in Patients Undergoing Transcatheter Aortic Valve Replacement: JACC State-of-the-Art Review Valve‐in‐Valve for Degenerated Transcatheter Aortic Valve Replacement Versus Valve‐in‐Valve for Degenerated Surgical Aortic Bioprostheses: A 3‐Center Comparison of Hemodynamic and 1‐Year Outcome

Original Research2021 Jan 3.

JOURNAL:Clin Res Cardiol. Article Link

Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis

G Bugani, M Pagnesi, D Tchetchè et al. Keywords: TAVR; balloon-expandable valve; bicuspid; high residual gradient; self-expandable valve;

ABSTRACT

OBJECTIVES - To define the incidence of high residual gradient (HRG) after transcatheter aortic valve replacement (TAVR) in BAVs and their impact on short term outcome and 1-year mortality.


BACKGROUND - Transcatheter heart valves (THVs) offer good performance in tricuspid aortic valves with low rate of HRG. However, data regarding their performance in bicuspid aortic valves (BAV) are still lacking.


METHODS - The BEAT (Balloon vs Self-Expandable valve for the treatment of bicuspid Aortic valve sTenosis) registry included 353 consecutive patients who underwent TAVR (Evolut R/PRO or Sapien 3 valves) in BAV between June 2013 and October 2018. The primary endpoint was device unsuccess with post-procedural HRG (mean gradient20 mmHg). The secondary endpoint was to identify the predictors of HRG following the procedure.


RESULTS - Twenty patients (5.6%) showed HRG after TAVR. Patients with HRG presented higher body mass index (BMI) (30.7 ± 9.3 vs. 25.9 ± 4.8; p < 0.0001) and higher baseline aortic mean gradients (57.6 ± 13.4 mmHg vs. 47.7 ± 16.6, p = 0.013) and more often presented with BAV of Sievers type 0 than patients without HRG. At multivariate analysis, BMI [odds ratio (OR) 1.12; 95% confidence interval (CI) 1.051.20, p = 0.001] and BAV type 0 (OR 11.31, 95% CI 3.4537.06, p < 0.0001) were confirmed as independent predictors of high gradient.


CONCLUSION - HRG following TAVR in BAVs is not negligible and is higher among patients with high BMI and with BAV 0 anatomy.