Hemodynamic results and changes in myocardial function after transcatheter aortic valve implantation

Gotzmann, Michael; Lindstaedt, Michael; Bojara, Waldemar; Mügge, Andreas; Germing, Alfried

doi:10.1016/j.ahj.2010.02.030

Cited by 88 publications

(51 citation statements)

References 21 publications

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“…Earlier echocardiography studies equally revealed inconsistent results on this topic with a reduction of LV diameters 29,30 in some publications, whereas in others, no significant changes were found. 27,28 Interestingly, this reduction of EDV could be observed despite a significant increase of AR in the entire cohort. This might be attributable to a statistical rather than a physiological effect because there was no decrease in EDV in the subgroup of patients with AR more than or equal to grade II; in the larger group of patients with AR less than or equal to grade I, however, the decrease was significant.…”

Section: Discussionmentioning

confidence: 96%

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Aortic Regurgitation and Left Ventricular Remodeling After Transcatheter Aortic Valve Implantation

Merten

Beurich

Zachow

et al. 2013

Circ: Cardiovascular Interventions

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all patients treated with TAVI at our institution were screened for inclusion into this prospective study (n=170; Figure 1). Indication for TAVI was in concordance with the recent consensus statement.18 Data collection was approved by the Institutional Review Board, and all patients signed an informed written consent. Patients with a contraindication to MRI (eg, pre-or post-TAVI pacemakers or MRI incompatible implants) and patients with claustrophobia, severe arrhythmias, or unstable clinical conditions were excluded from the study. Ultimately, a total of 55 consecutive patients treated with TAVI with the use of the 2 currently commercially available bioprostheses (Medtronic CoreValve, Background-Aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) has been associated with poor outcomes, but little is known about how it evolves over time. We evaluated left ventricular (LV) function, remodeling, and the occurrence and evolution of AR after TAVI by using cardiac MRI. Methods and Results-Forty-three patients treated with transfemoral TAVI underwent cardiac MRI 1 week and 6 months after TAVI. LV volumes and function were assessed by using standard cine MRI sequences. Phase-contrast imaging was performed to quantify the degree of AR. The mean age of the evaluated patients was 80 years, and 65% of patients were women. At baseline MRI, the median LV ejection fraction was 58.1%, which improved significantly at follow-up to 63.4% (P<0.0001). A significant reduction of LV end-diastolic volume (149.7±41.4-140.1±43.9 mL; P=0.014) and of LV mass (156.3±32.8-142.7±39.3 g; P<0.001) was observed. Over time, aortic regurgitant fraction increased slightly but significantly from 5.2% to 7.8% (P=0.04). Subgroup analysis revealed that significant changes of LV ejection fraction, volumes, and mass only occurred in patients with no or mild AR at baseline MRI, whereas those parameters remained unchanged in patients with AR more than or equal to grade II. Conclusions-By using cardiac MRI in patients with TAVI, a significant improvement of LV function, volume, and mass can be documented. Mild-to-moderate AR is commonly seen, and AR shows a small increase over time. More-than-mild AR seems to prevent LV functional and structural recovery after TAVI.

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Section: Discussionmentioning

confidence: 96%

“…Several studies found unchanged LVEF during follow-up of up to 1 year after TAVI, 27,28 whereas in others, a highly significant increase of LVEF was observed. [29][30][31][32][33] In all of these studies, LV function was assessed by echocardiography.…”

Section: Discussionmentioning

confidence: 99%

Aortic Regurgitation and Left Ventricular Remodeling After Transcatheter Aortic Valve Implantation

Merten

Beurich

Zachow

et al. 2013

Circ: Cardiovascular Interventions

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“…Normalization of LV diastolic function [31] and benefit in ejection fraction, volumes, and hypertrophy are observed at long-term follow-up [32]. Gotzmann et al [33] have determined improvement in diastolic function at 6-month follow-up in patients undergoing TAVI with CoreValve prosthesis.…”

Section: Discussionmentioning

confidence: 99%

Immediate recovery of the left atrial and left ventricular diastolic function after transcatheter aortic valve implantation: A transesophageal echocardiography study

Sarı

Aslan²,

Baştuğ³

et al. 2016

Cardiol J.

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LV diastolic function was also explored by pulsed tissue Doppler imaging (TDI). Early (E') and late (A') diastolic annular velocities, E'/A' ratio and E/E' ratio were obtained. In addition, during the procedure before and minutes after the valve implantation, the left atrial appendage-peak antegrade flow velocity (LAA-PAFV) was measured and recorded with TEE.Results: Compared with baseline, the mean mitral E, septal E' and E'/A' ratio increased significantly after TAVI. In addition, the LAA-PAFV increased significantly within minutes of TAVI (32.45 ± 10.7 cm/s vs. 47.6 ± 12.6 cm/s, p < 0.001

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“…The safety and effectiveness of this new technique has been demonstrated, as well as sustained transvalvular hemodynamics post-TAVI has also shown significant improvement in symptoms [1,2]. Despite data favoring low transprosthetic gradients and large prosthetic valve effective orifice area in several studies [3][4][5][6], the assumption that implantation of a percutaneous bioprosthesis within the native valve might lead to incomplete expansion of the prosthetic valve [7] is still worrisome, since the evidence in individual continuous hemodynamic change has been lacking.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic changes after transcatheter aortic valve implantation during sequential follow-ups in patients with bicuspid aortic valve compared with tricuspid aortic valve

et al. 2017

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[-0.25, 5.00] mm Hg, p = 0.57 at 1 month; p = 0.21 at 3 months; 0.96 ± 7.81 vs. 1.53 ± 5.85 mm Hg, p = 0.79 at 6 months; 2.25] vs. 3.00 [-0.50, 7.50] mm Hg, p = 0.07 at 1 year). Moreover, the incidence of ≥ mild PVL was not significantly different in patients with p = 0.14 at 1 month; 45.83% vs. 27.27%, p = 0.19 at 3 months; 30.00% vs. 23.53%, p = 0.89 at 6 months; 30.00% vs. 17.65%, p = 0.56 at 1 year). Conclusions: TAVI is effective and applicable in BAV anatomy with sustained and acceptable mid--term prosthesis hemodynamic performance. (Cardiol J 2017; 24, 4: 350-357)

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Hemodynamic results and changes in myocardial function after transcatheter aortic valve implantation

Cited by 88 publications

References 21 publications

Aortic Regurgitation and Left Ventricular Remodeling After Transcatheter Aortic Valve Implantation

Aortic Regurgitation and Left Ventricular Remodeling After Transcatheter Aortic Valve Implantation

Immediate recovery of the left atrial and left ventricular diastolic function after transcatheter aortic valve implantation: A transesophageal echocardiography study

Hemodynamic changes after transcatheter aortic valve implantation during sequential follow-ups in patients with bicuspid aortic valve compared with tricuspid aortic valve

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