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Clinical Research in Cardiology

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30.03.2019 | Original Paper

Impact of valvular resistance on aortic regurgitation after transcatheter aortic valve replacement according to the type of prosthesis

verfasst von: Masahiko Asami, Thomas Pilgrim, Stefan Stortecky, Dik Heg, Eva Roost, Stephan Windecker, Lukas Hunziker

Erschienen in: Clinical Research in Cardiology | Ausgabe 12/2019

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Abstract

Background

The impact of aortic valvular resistance (VR) on the degree of post-transcatheter aortic valve replacement (TAVR) aortic regurgitation (AR) remains unclear. The objective of the study was to investigate the relationship between VR and paravalvular AR after TAVR.

Methods

Between August 2007 and December 2015, 708 TAVR patients had sufficient data to calculate VR before the intervention and were eligible for the present analysis. The patient population was dichotomized according to VR. The association between VR and post-TAVR AR was separately assessed by prosthesis type.

Results

Among patients with low VR (LVR; < 238 dynes/cm⁵), 176 (49.7%) patients were treated with balloon-expandable (BE) valves and 178 (51.3%) patients with self-expandable (SE) transcatheter valves. Among patients with high VR (HVR ≥ 238), 147 (41.5%) and 207 (68.5%) patients received BE and SE, respectively. Baseline characteristics were similar in both groups irrespective of the type of valve. Patients with HVR had a 2.5-fold risk of ≥ moderate post-TAVR AR compared to patients with LVR. Both, HVR (HR_adj 2.45, 95% CI 1.33–4.51) and the use of SE (HR_adj 3.11, 95% CI 1.66–5.82), emerged as independent predictors of ≥ moderate post-TAVR AR. Moderate or greater post-AR was consistently predicted in patients treated with SE (HR_adj 2.42, 95% CI 1.22–4.80) irrespective of the level of VR.

Conclusions

HVR is associated with a nearly 2.5-fold increased risk of moderate or greater post-TAVR AR and is an independent predictor of post-TAVR AR.

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Titel: Impact of valvular resistance on aortic regurgitation after transcatheter aortic valve replacement according to the type of prosthesis
verfasst von: Masahiko Asami
Thomas Pilgrim
Stefan Stortecky
Dik Heg
Eva Roost
Stephan Windecker
Lukas Hunziker
Publikationsdatum: 30.03.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 12/2019
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-019-01469-z

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Impact of valvular resistance on aortic regurgitation after transcatheter aortic valve replacement according to the type of prosthesis

Abstract

Background

Methods

Results

Conclusions

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

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