Impact of aortic valve calcification on the outcome of transcatheter aortic valve implantation: Results from the prospective multicenter German TAVI registry

Abstract

Our results of a real-world registry suggest that the extent of aortic valve calcification does not influence the success or procedural outcome significantly.

Degree of valve calcification in patients undergoing transfemoral transcatheter aortic valve implantation with and without balloon aortic valvuloplasty: Findings from the multicenter EASE‐IT TF registry

“…Importantly, neither regional calcification nor asymmetry differed significantly between patients that met the 30‐day VARC‐2 composite endpoint and those that did not, suggesting that early safety is not directly affected by the degree or distribution of calcification. This is in agreement with findings from the multicenter German TAVI registry, which also found calcification to be unrelated to the frequency of death, stroke, and MI at 30 days . Also consistent with the literature are the higher frequencies of clinically relevant mitral regurgitation, mitral stenosis, and PVL in patients experiencing poorer outcomes post‐TAVI, supporting the validity and pertinence of our data.…”

Prognostic value of aortic root calcification volume on clinical outcomes after transcatheter balloon‐expandable aortic valve implantation

“…It remains unclear whether aortic valve calcification affects clinical outcomes after TAVI or not. The German TAVI‐registry showed that the extent of aortic valve calcification does not influence the success or procedural outcome significantly . In this German TAVI‐registry, 80.8% of patients were treated by CoreValve implantation and the assessment of aortic valve calcification was performed visually by the investigator.…”

Aortic valve calcification and the performance of TAVI: Bad actor or part of the scenery?

“…It appears teleological that the degree of valvular calcification magnifies this risk. Staubach et al [2] have not confirmed this relationship. Similarly, Erkipac et al [5] in a comprehensive review of the published literature surrounding the outcome of PPI following TAVI were not able to identify aortic valve characteristics predictive of the need for PPI.…”

“…In this issue of Catheterization and Cardiovascular Interventions, Staubach et al examine the effect of aortic valve calcification on TAVI outcome in a prospective multicenter German registry [2]. In this study, the investigators analyzed the clinical outcomes of 1,365 patients undergoing TAVI, qualitatively categorizing their patients into three groups based on the degree of aortic valve calcification (mild, moderate, and severe).…”

“…In this analysis, the pre-procedural imaging used to categorize severity of aortic valve calcium did not show an ability to discriminate differences in outcomes. As the authors note, this registry [2] did not have prespecified definitions regarding valvular calcium severity for the imaging modalities used to determine aortic valve calcium-no core lab was utilized with the obvious potential for inter-observer variability in how valvular calcification was scored. The lack of uniform criteria could impact on how patients are categorized relative to calcium severity and this may affect the interpretation of outcomes.…”