Premium
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
Author(s) -
Butter Christian,
Okamoto Maki,
Schymik Gerhard,
Jacobshagen Claudius,
Rothe Jürgen,
Treede Hendrik,
Kerber Sebastian,
Frank Derk,
Bramlage Peter,
Sykorova Lenka,
Thoenes Martin,
Rudolph Tanja K.
Publication year - 2019
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.28164
Subject(s) - medicine , calcification , aortic valvuloplasty , cardiology , aortic valve , radiology , balloon , aortic valve stenosis
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 and results 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.