Impact of Ascending Aorta Dilation on Mid-Term Outcome After Transcatheter Aortic Valve Implantation.
Aged, 80 and over
Aortic Aneurysm, Thoracic
/ complications
Aortic Rupture
/ diagnosis
Aortic Valve Stenosis
/ diagnosis
Female
Follow-Up Studies
Humans
Incidence
Italy
/ epidemiology
Male
Postoperative Complications
/ diagnosis
Retrospective Studies
Severity of Illness Index
Survival Rate
/ trends
Time Factors
Tomography, X-Ray Computed
Transcatheter Aortic Valve Replacement
/ adverse effects
aortic stenosis
transcatheter aortic valve implantation
Journal
The Journal of invasive cardiology
ISSN: 1557-2501
Titre abrégé: J Invasive Cardiol
Pays: United States
ID NLM: 8917477
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
pubmed:
16
9
2019
medline:
24
3
2020
entrez:
16
9
2019
Statut:
ppublish
Résumé
Severe aortic stenosis (AS) is often associated with ascending aorta dilation (AAD). AAD is amenable to surgical correction combined with aortic valve replacement. Transcatheter aortic valve implantation (TAVI) might represent a valid therapeutic option in these patients when AAD correction Is not indicated. The aim of the present study is to evaluate the impact of concomitant AAD on early and mid-term outcomes after TAVI for symptomatic severe AS. This is a single-center observational study including patients undergoing transfemoral TAVI. All patients with previous surgery on the left ventricular outflow tract, aortic valve, or ascending aorta (except coronary artery bypass graft surgery) were excluded from the analysis. Patients undergoing TAVI for congenital aortic valve defects or subjects in whom a computed tomography (CT) scan was not available were excluded from the analysis. Ascending aortas were measured on CT scans using appropriate multiplanar reconstructions. Ascending aortas were qualified as dilated if the measurement was >40 mm. Study outcomes were death from any cause, significant paravalvular leaks (PVLs), and new permanent pacemaker (PPM) implant. The final population consisted of 680 subjects, 61% females, mean age 82 ± 7 years. One hundred subjects (15%) had AAD. No differences in terms of significant PVL or PPM implantation were found between subjects with or without AAD (P>.99 and P=.13, respectively). At a median follow-up of 498 ± 216 days, no significant difference in terms of mortality was found between subjects with or without AAD (P=.78). AAD does not appear to impact the mid-term outcomes in a cohort of subjects undergoing TAVI.
Sections du résumé
BACKGROUND
BACKGROUND
Severe aortic stenosis (AS) is often associated with ascending aorta dilation (AAD). AAD is amenable to surgical correction combined with aortic valve replacement. Transcatheter aortic valve implantation (TAVI) might represent a valid therapeutic option in these patients when AAD correction Is not indicated. The aim of the present study is to evaluate the impact of concomitant AAD on early and mid-term outcomes after TAVI for symptomatic severe AS.
METHODS
METHODS
This is a single-center observational study including patients undergoing transfemoral TAVI. All patients with previous surgery on the left ventricular outflow tract, aortic valve, or ascending aorta (except coronary artery bypass graft surgery) were excluded from the analysis. Patients undergoing TAVI for congenital aortic valve defects or subjects in whom a computed tomography (CT) scan was not available were excluded from the analysis. Ascending aortas were measured on CT scans using appropriate multiplanar reconstructions. Ascending aortas were qualified as dilated if the measurement was >40 mm. Study outcomes were death from any cause, significant paravalvular leaks (PVLs), and new permanent pacemaker (PPM) implant.
RESULTS
RESULTS
The final population consisted of 680 subjects, 61% females, mean age 82 ± 7 years. One hundred subjects (15%) had AAD. No differences in terms of significant PVL or PPM implantation were found between subjects with or without AAD (P>.99 and P=.13, respectively). At a median follow-up of 498 ± 216 days, no significant difference in terms of mortality was found between subjects with or without AAD (P=.78).
CONCLUSIONS
CONCLUSIONS
AAD does not appear to impact the mid-term outcomes in a cohort of subjects undergoing TAVI.
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM