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Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world
Author(s) -
Arai Takahide,
Lefèvre Thierry,
Hovasse Thomas,
Garot Philippe,
Benamer Hakim,
Unterseeh Thierry,
Roy Andrew K.,
Romano Mauro,
Hayashida Kentaro,
Watanabe Yusuke,
Bouvier Erik,
Morice MarieClaude,
Chevalier Bernard
Publication year - 2017
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26982
Subject(s) - medicine , incidence (geometry) , cardiology , prosthesis , aortic valve , complication , aortic valve replacement , surgery , stenosis , physics , optics
Objectives Coronary obstruction (CO) is a rare but serious complication of transcatheter aortic valve implantation (TAVI). There are very limited data regarding CO following TAVI. The aim of this study was to evaluate the incidence and outcomes of CO after TAVI and identify the predictors including the valve type. Methods Between October 2006 and March 2015, 1,203 TAVI cases were performed in our institution. Of them, 814 cases whose coronary height was measured using computed tomography for screening were analyzed in this study. Results The Edwards SAPIEN/SAPIEN XT (S/XT) was used in 427 (52.4%) cases, the CoreValve in 265 (32.6%), and the S3 in 122 (15.0%). CO occurred in 8 (1.0%) cases, 1.6% with S/XT, 0.4% with CoreValve, and 0% with S3. All instances of CO occurred at the left coronary artery. The 30‐day mortality was significantly higher in cases of CO (37.5% vs. 5.8%, P = 0.010). The frequency of CO tended to be lower in recipients of the CoreValve (0.4%) and S3 (0%) compared with the S/XT (1.6%) ( P = 0.188 for CoreValve vs. S/XT, P = 0.022 for S3 vs. S/XT). Conclusions CO has poor outcomes and identification of patients at risk of CO to take preventive measures is crucial. The preliminary data showing that the occurrence of CO is low in patients receiving the S3 despite increased prosthesis height need further confirmation. © 2017 Wiley Periodicals, Inc.