Objective Transcatheter aortic valve implantation (TAVI) provokes early injury response, represented in part by dynamic changes in the inflammatory markers. The association of self-expanding valves (SEVs) and balloon-expandable valves (BEVs) with the consequent inflammatory response remains uncertain. Materials and methods Patients with severe symptomatic aortic stenosis who underwent transfemoral TAVI: SEVs or BEVs, from January 2010 to December 2019 were enrolled. Whole white blood cells (WBC) and subpopulation dynamics as well the neutrophil to lymphocyte ratio (NLR) were evaluated. Results Three-hundred seventy consecutive patients (mean age 81.75 ± 6.8 years, 199 women’s) were enrolled. In the entire population, significant kinetic changes in the WBC response (p <0.0001) between admission and first 24 hours post procedure, with a significant increase in total WBC (7.46 ± 2.26 to 10.08 ± 3.55) and absolute neutrophil count (4.97 ± 2.06 to 8.19 ± 3.43), NL ratio (3.72 ± 2.8 to 9.76 ± 7.29), and a meaningful decrease in absolute lymphocytes count (1.67 ± 1.1 to 1.1 ± 0.76). When compared between the types of valves, SEVs were associated with a more pronounced inflammatory response than BEVs, with total WBC (10.44 ± 3.86 vs. 9.45 ± 3.19) neutrophils (8.56 ± 3.75 vs. 7.55 ± 3.06) with p 0.016 and 0.012 respectively. Conclusion This is the first description of a differential inflammatory response between the two leading delivery systems. SEV appears to trigger a more robust inflammatory response as compared to BEV. Clinical studies are warranted to assess the long term effect of our findings.

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Background: Transcatheter aortic valve implantation (TAVI) has emerged as an effective and safe treatment for severe aortic stenosis in the last decades compared for surgical aortic valve replacement. However, it stills associated with high risk of conduction abnormalities requiring pacemaker implantation. Our study aimed to examine factors associated with transient conduction abnormities that don’t require pacemaker on long term. Methods: Retrospective analysis of all consecutive patients who underwent TAVI between 2010 and 2019 in Kaplan Medical Center, Rehovot, Israel. Results: Pre-TAVI haemoglobin levels were significantly lower in patients who developed transient CA compared to patients who develop persistent conduction abnormalities and were pacemaker dependent on follow up. Similarly, urea levels were higher in in patients with transient conduction abnormalities. Conclusion: Transient conduction abnormalities following TAVI are not uncommon. Correction of anaemia and volume depletion prior to TAVI may decrease the incidence of these transient conduction abnormalities and hence, decrease the fraction of unnecessary permanent pacemaker implantations in the long term. Watchful waiting may be wise in anaemic patients who develop CA after TAVI. The cut-off for haemoglobin levels prior to TAVI is yet to be determined.

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