Impact of moderate or severe left ventricular outflow tract calcification on clinical outcomes of patients with severe aortic stenosis undergoing transcatheter aortic valve implantation with self- and balloon-expandable valves: a post hoc analysis from the SOLVE-TAVI trial
Background: Left ventricular outflow tract (LVOT) calcification has been associated with worse outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) and may influence the selection of prosthetic valve type. Aims: We aimed to evaluate the impact of LVOT calcification on outco...
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| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2022
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| In: |
EuroIntervention
Year: 2022, Jahrgang: 18, Heft: 9, Pages: 759-768 |
| ISSN: | 1969-6213 |
| DOI: | 10.4244/EIJ-D-22-00156 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://dx.doi.org/10.4244/EIJ-D-22-00156
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| Verfasserangaben: | Serdar Farhan, Georg Stachel, Steffen Desch, Thomas Kurz, Hans-Josef Feistritzer, Philipp Hartung, Ingo Eitel, Holger Nef, Oliver Doerr, Alexander Lauten, Ulf Landmesser, Marcus Sandri, David Holzhey, Michael Borger, Hüseyin Ince, Alper Öner, Roza Meyer-Saraei, Harm Wienbergen, Andreas Fach, Norbert Frey, Suzanne de Waha-Thiele, Holger Thiele |
MARC
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| 245 | 1 | 0 | |a Impact of moderate or severe left ventricular outflow tract calcification on clinical outcomes of patients with severe aortic stenosis undergoing transcatheter aortic valve implantation with self- and balloon-expandable valves |b a post hoc analysis from the SOLVE-TAVI trial |c Serdar Farhan, Georg Stachel, Steffen Desch, Thomas Kurz, Hans-Josef Feistritzer, Philipp Hartung, Ingo Eitel, Holger Nef, Oliver Doerr, Alexander Lauten, Ulf Landmesser, Marcus Sandri, David Holzhey, Michael Borger, Hüseyin Ince, Alper Öner, Roza Meyer-Saraei, Harm Wienbergen, Andreas Fach, Norbert Frey, Suzanne de Waha-Thiele, Holger Thiele |
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| 520 | |a Background: Left ventricular outflow tract (LVOT) calcification has been associated with worse outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) and may influence the selection of prosthetic valve type. Aims: We aimed to evaluate the impact of LVOT calcification on outcomes after TAVI with a self-expanding valve (SEV) versus a balloon-expandable valve (BEV). Methods: Patients of the SOLVE-TAVI trial, randomised to Edwards SAPIEN 3 or Medtronic Evolut R, were divided according to LVOT calcification into no/mild (≤1 calcium nodule extending <5 mm and covering <10% of the LVOT perimeter) and moderate/severe LVOT calcification groups. The primary endpoint was a composite of death, stroke, moderate/severe paravalvular regurgitation, permanent pacemaker implantation and annulus rupture at 30 days. Additional endpoints included all-cause and cardiovascular mortality at 1 year. Results: Out of 416 eligible patients, moderate/severe LVOT calcification was present in 143 (34.4%). Moderate/severe LVOT calcification was associated with significantly longer fluoroscopy time and higher rates of pre- and post-dilation. Regardless of the LVOT calcification group, there was no significant difference in the primary endpoint associated with the valve type (no/mild LVOT calcification group: SEV 25.0% vs BEV 27.0%; hazard ratio [HR] 1.10, 95% confidence interval [95% CI]: 0.68-1.73; p=0.73 and moderate/severe LVOT calcification group: SEV 25.0% vs BEV 19.4%; HR 0.76, 95% CI: 0.38-1.61; p=0.49), no significant interaction between LVOT calcification and valve type (pint=0.29) and no differences between SEV vs BEV within LVOT calcification groups regarding 1-year all-cause and cardiovascular mortality. Conclusions: Moderate/severe LVOT calcification was associated with longer fluoroscopy time and an increased need for pre- and post-dilation, but not with a higher incidence of early and mid-term adverse clinical outcomes, regardless of valve type. (ClinicalTrials.gov: NCT02737150) | ||
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| 700 | 1 | |a Desch, Steffen |e VerfasserIn |4 aut | |
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| 700 | 1 | |a Wienbergen, Harm |e VerfasserIn |4 aut | |
| 700 | 1 | |a Fach, Andreas |e VerfasserIn |4 aut | |
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| 700 | 1 | |a De Waha-Thiele, Suzanne |e VerfasserIn |4 aut | |
| 700 | 1 | |a Thiele, Holger |e VerfasserIn |4 aut | |
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