Calcium Load in the Aortic Valve, Aortic Root, and Left Ventricular Outflow Tract and the Risk for a Periprocedural Stroke.
Cerebral protection device
Outcome
TAVR
Transcatheter aortic valve replacement
Journal
Structural heart : the journal of the Heart Team
ISSN: 2474-8714
Titre abrégé: Struct Heart
Pays: United States
ID NLM: 101743256
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
received:
04
03
2022
revised:
07
06
2022
accepted:
17
06
2022
medline:
8
6
2023
pubmed:
8
6
2023
entrez:
8
6
2023
Statut:
epublish
Résumé
Periprocedural stroke during transcatheter aortic valve implantation is a rare but devastating complication. The calcified aortic valve is the most likely source of the emboli in a periprocedural stroke. The total load and distribution of calcium in the leaflets, aortic root, and left ventricular outflow tract varies from patient to patient. Consequently, there could be patterns of calcification that are associated with a higher risk of stroke. This study aimed to explore whether the pattern of calcification in the left ventricular outflow tract, annulus, aortic valve, and ascending aorta can be used to predict a periprocedural stroke. Among the 3282 consecutive patients who received a transcatheter aortic valve implantation in the native valve in Sweden from 2014 to 2018, we identified 52 who had a periprocedural stroke. From the same cohort, a control group of 52 patients was constructed by propensity score matching. Both groups had one missing cardiac computed tomography, and 51 stroke and 51 control patients were blindly reviewed by an experienced radiologist. The groups were well balanced in terms of demographics and procedural data. Of the 39 metrics created to describe calcium pattern, only one differed between the groups. The length of calcium protruding above the annulus was 10.6 mm (interquartile range 7-13.6) for patients without stroke and 8 mm (interquartile range 3-10) for stroke patients. This study could not find any pattern of calcification that predisposes for a periprocedural stroke.
Sections du résumé
Background
UNASSIGNED
Periprocedural stroke during transcatheter aortic valve implantation is a rare but devastating complication. The calcified aortic valve is the most likely source of the emboli in a periprocedural stroke. The total load and distribution of calcium in the leaflets, aortic root, and left ventricular outflow tract varies from patient to patient. Consequently, there could be patterns of calcification that are associated with a higher risk of stroke. This study aimed to explore whether the pattern of calcification in the left ventricular outflow tract, annulus, aortic valve, and ascending aorta can be used to predict a periprocedural stroke.
Methods
UNASSIGNED
Among the 3282 consecutive patients who received a transcatheter aortic valve implantation in the native valve in Sweden from 2014 to 2018, we identified 52 who had a periprocedural stroke. From the same cohort, a control group of 52 patients was constructed by propensity score matching. Both groups had one missing cardiac computed tomography, and 51 stroke and 51 control patients were blindly reviewed by an experienced radiologist.
Results
UNASSIGNED
The groups were well balanced in terms of demographics and procedural data. Of the 39 metrics created to describe calcium pattern, only one differed between the groups. The length of calcium protruding above the annulus was 10.6 mm (interquartile range 7-13.6) for patients without stroke and 8 mm (interquartile range 3-10) for stroke patients.
Conclusions
UNASSIGNED
This study could not find any pattern of calcification that predisposes for a periprocedural stroke.
Identifiants
pubmed: 37288334
doi: 10.1016/j.shj.2022.100070
pii: S2474-8706(22)01860-7
pmc: PMC10242559
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100070Informations de copyright
© 2022 The Author(s).
Déclaration de conflit d'intérêts
H. Bjursten has served as a consultant for Boston Scientific and Edwards Lifesciences. N. Samano received honorarium from Edwards Lifesciences. A. Rück has served as a consultant and received research support from 10.13039/100008497Boston Scientific and 10.13039/100006520Edwards Lifesciences. S. James received proctoring fees from Medtronic. M. Settergren has served as a consultant and advisory boards for Boston Scientific, Edwards Lifesciences, Abbott Vascular, and WL Gore. M. Götberg has served as a consultant for Boston Scientific. The other authors had no conflicts to declare.
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