The Effect of Transcatheter Aortic Valve Implantation on Pulmonary Hypertension

Background and Aim Pulmonary hypertension ( PH ) is common in patients with severe aortic stenosis ( AS ). The prognostic effect of PH in high‐risk patients undergoing transcatheter aortic valve implantation ( TAVI ) remains unknown. The aim of this study was to examine the feasibility of TAVI in patients with PH and to determine the effect of TAVI on PH . Methods and Results TAVI was performed in 70 patients (mean age, 77.6 years; 51 females and 19 males) between July 2011 and December 2012, in our hospital. The patients were divided into three groups based on their systolic pulmonary artery pressure ( sPAP ) values. Group 1 comprised patients with sPAP values <40 mmHg; group 2 included patients with sPAP values ranging from 40 to 59 mmHg; and group 3 included patients with sPAP values >60 mmHg. Seventy percent of the patients were in groups 2 and 3. After TAVI , the sPAP values of the patients in groups 2 and 3 were significantly decreased (47.4 ± 4.6 and 36.6 ± 6.3, P < 0.001 and 64.5 ± 4.7 and 43.2 ± 9.2, P < 0.001, respectively). However, this reduction was sustained for 6 months in group 2 (P = 0.006), whereas the reduction lost its statistical significance (P = 0.07) after 1 month in group 3 (64.5 ± 4.7 and 40.8 ± 8.0, P = 0.001). Significant differences between the sPAP values in all three groups before the procedure were sustained after TAVI (P ≤ 0.001) and after the 1st month (P = 0.02); however, no statistically significant difference was observed after the 6th month (P = 0.06). Conclusion In this study, we demonstrated that TAVI could be reliably and successfully performed in PH patients with severe AS and that TAVI results in a permanent and significant reduction in sPAP .