Calcification of Aortic Valve Is Not Associated with Neurologic Events or Need for Pacemaker Implantation in TAVI Patients

Morlock, Julia; Schlick, Susanne F.; Psyrakis, Dimitrios; Sorg, Stefan; Schröfel, Holger; Beyersdorf, F; Reinöhl, Jochen; Heilmann, Claudia

doi:10.1055/s-0036-1571566

Cited by 1 publication

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“…Paravalvular leakage, itself associated with a detrimental effect on prognosis [ 9 ], was found significantly more often in patients with a high calcification burden of the aortic valve [ 5 ]. The impact on stroke remains unclear, with some studies finding no correlation [ 10 , 11 ], while newer data reported by Spaziano et al found a two-fold increase in the stroke rate and mortality at one year following TAVI in patients with moderate or severe left ventricular outflow tract (LVOT) calcification [ 6 ]. Furthermore, a study by Aggarwal et al reported a significantly higher number of cranial embolization in patients with a higher valvular Agatston score [ 12 ].…”

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confidence: 99%

Hemodynamic Performance of Two Current-Generation Transcatheter Heart Valve Prostheses in Severely Calcified Aortic Valve Stenosis

Potratz

Mohemed

Omran

et al. 2022

JCM

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Background: Treatment of severely calcified aortic valve stenosis is associated with a higher rate of paravalvular leakage (PVL) and permanent pacemaker implantation (PPI). We hypothesized that the self-expanding transcatheter heart valve (THV) prostheses Evolut Pro (EPro) is comparable to the balloon-expandable Sapien 3 (S3) regarding hemodynamics, PPI, and clinical outcome in these patients. Methods: From 2014 to 2019, all patients with very severe calcification of the aortic valve who received an EPro or an S3 THV were included. Propensity score matching was utilized to create two groups of 170 patients. Results: At discharge, there was significant difference in transvalvular gradients (EPro vs. S3) (dPmean 8.1 vs. 11.1 mmHg, p ≤ 0.001) and indexed effective orifice area (EOAi) (1.1 vs. 0.9, p ≤ 0.001), as well as predicted EOAi (1 vs. 0.9, p ≤ 0.001). Moderate patient prosthesis mismatch (PPM) was significantly lower in the EPro group (17.7% vs. 38%, p ≤ 0.001), as well as severe PPM (2.9% vs. 8.8%, p = 0.03). PPI and the PVL rate as well as stroke, bleeding, vascular complication, and 30-day mortality were comparable. Conclusions: In patients with severely calcified aortic valves, both THVs performed similarly in terms of 30-day mortality, PPI rate, and PVL occurrence. However, patient prothesis mismatch was observed more often in the S3 group, which might be due to the intra-annular design.

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