Short and medium-term outcomes of patients with and without left ventricular dysfunction submitted to transcatheter aortic valve implantation

Verri, Paulo Henrique; Meneguz‐Moreno, Rafael Alexandre; Teixeira, Felipe Rodrigues da Costa; Etto, Juliana Paixão; Gomes, Marília Cristina Cunha; Jeronimo, Andreia Dias; Ramos, Auristela Isabel de Oliveira; Siqueira, Dimytri; Abizaid, Alexandre; Sousa, Amanda G. M. R.; Sousa, J. Eduardo

doi:10.1016/j.rbciev.2015.12.011

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…A surgical history of CAD is one of the most common risk factors for patients undergoing valve implantation or replacement [ [12] , [13] , [14] ], especially for patients with prior CABG. Patients with prior CABG undergoing TAVIR have higher risks of death and major complications.…”

Section: Introductionmentioning

confidence: 99%

Association between transcatheter aortic valve implantation or replacement and mortality, and major adverse events after coronary artery bypass grafting

Zheng

2018

IJC Heart & Vasculature

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BackgroundIn recent years, many people are opting for minimally invasive surgery in China. Patients undergoing transcatheter aortic valve implantation or replacement (TAVIR) with previous coronary artery bypass grafting (CABG) have higher risks of death and major complications.Materials/methodsPubMed and Embase were searched for all comparison studies between TAVIR with and without prior CABG and mortality as a primary outcome, irrespective of surgical risk, to investigate whether patients with prior CABG can undergo TAVIR. Randomized controlled trials and propensity-score-matched cohort studies were eligible for inclusion. The outcomes of interest included 30-day, 6-month, and 1-year mortality and 30-day complications. If significant heterogeneity was found in the random-effects meta-analyses, a sensitivity analysis that individually removed each study was conducted.ResultsFive studies reported results on patients undergoing TAVIR with or without prior CABG. Compared with the non-CABG cohort, the CABG cohort showed no significant difference in the 30-day, 6-month, and 1-year mortality and the 30-day risk of major complications, except life-threatening bleeding. However, for the 30-day risk of life-threatening bleeding, the morbidity of CABG cohort was significantly lower than that of the non-CABG cohort (risk ratio 0.555; 95% confidence interval 0.35–0.85; P = 0.006; I2 = 0%).ConclusionsPatients with prior CABG can undergo TAVIR. Patients undergoing TAVIR without prior CABG need more attention because of a higher risk of life-threatening bleeding.

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Section: Introductionmentioning

confidence: 99%

Association between transcatheter aortic valve implantation or replacement and mortality, and major adverse events after coronary artery bypass grafting

Zheng

2018

IJC Heart & Vasculature

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Effect of percutaneous aortic valve position on stress map in ascending aorta: A fluid‐structure interaction analysis

2021

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Transcatheter aortic valve implantation (TAVI) is an increasingly widespread procedure. Although this intervention is indicated for high and low surgical risk patients, some issues still remain, such as prosthesis positioning optimization in the aortic annulus. Coaxial positioning of the percutaneous prosthesis influences directly on the aortic wall stress map. The determination of the mechanical stress that acts on the vascular endothelium resulting from blood flow can be considered an important task, since TAVI positioning can lead to unfavorable hemodynamic patterns, resulting in changes in parietal stress, such as those found in post‐stenotic dilatation region. This research aims to investigate the influence of the prosthetic valve inclination angle in the mechanical stresses acting in the ascending aortic wall. Aortic compliance and blood flow during cardiac cycle were numerically obtained using fluid structure interaction. The aortic model was developed through segmentation of a computed tomography image of a specific patient submitted to TAVI. When compared to standard position (coaxiality match between the prosthesis and the aortic annulus), the inclination of 4° directed to the left main coronary artery decreased the aortic wall area with high values of wall shear stress and pressure. Coaxial positioning optimization of percutaneous aortic prosthesis may decrease the high mechanical stress area. These changes may be important to reduce the aortic remodeling process, vascular calcification or even the prosthesis half‐life. Computational fluid dynamics makes room for personalized medicine, with manufactured prosthesis tailored to each patient.

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Short and medium-term outcomes of patients with and without left ventricular dysfunction submitted to transcatheter aortic valve implantation

Cited by 2 publications

References 19 publications

Association between transcatheter aortic valve implantation or replacement and mortality, and major adverse events after coronary artery bypass grafting

Association between transcatheter aortic valve implantation or replacement and mortality, and major adverse events after coronary artery bypass grafting

Effect of percutaneous aortic valve position on stress map in ascending aorta: A fluid‐structure interaction analysis

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