Open AccessMicro-dislodgement during transcatheter aortic valve implantation with a contemporary self-expandable prosthesis
Author(s) -
Katharina Hellhammer,
Kerstin Piayda,
Shazia Afzal,
Verena Veulemans,
Inga Hennig,
Matthias Makosch,
Amin Polzin,
Malte Kelm,
Tobias Zeus
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0224815
Subject(s) - medicine , prosthesis , hemodynamics , cardiology , aortic valve , incidence (geometry) , risk factor , surgery , geometry , mathematics
Objectives To evaluate the incidence, risk factors and the clinical outcome of micro-dislodgement (MD) with a contemporary self-expandable prosthesis during transcatheter aortic valve implantation. Methods MD was defined as movement of the prosthesis of at least 1.5 mm upwards or downwards from its position directly before release compared to its final position. Patients were grouped according to the occurrence (+MD) or absence (-MD) of MD. Baseline characteristics, imaging data and outcome parameters were retrospectively analyzed. Results We identified 258 eligible patients. MD occurred in 31.8% (n = 82) of cases with a mean magnitude of 2.8 mm ± 2.2 in relation to the left coronary cusp and 3.0 mm ± 2.1 to the non-coronary cusp. Clinical and hemodynamic outcomes were similar in both groups with consistency over a follow-up period of three months. A larger aortic valve area (AVA) (-MD vs. +MD: 0.6 cm 2 ± 0.3 vs. 0.7cm 2 ± 0.2; p = 0.014), was the only independent risk factor for the occurrence of MD in a multivariate regression analysis (OR 5.3; 95% CI: 1.1–24.9; p = 0.036). Conclusions MD occurred in nearly one third of patients and did not affect clinical and hemodynamic outcome. A larger AVA seems to be a potential risk factor for MD.