Strut Inversion During Valve-in-Valve Transcatheter Aortic Valve Replacement

Batta, Akash; Satish, Sai; Rajan, Ajay; Sonawane, Anmol; Sihag, Bhupendra Kumar; Barwad, Parag

doi:10.1016/j.jaccas.2021.12.015

Cited by 2 publications

(1 citation statement)

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“…If not planned appropriately, there are major complications that can occur, even mortality, e.g., significant paravalvular leak, valve embolization, annular rupture, coronary occlusion, conduction disturbance, etc. Even rare complications like strut inversion in the background of calcium spur have been reported [ 4 ]. The purpose of this paper is to establish the concept of contrast frugal technique that can be done safely without any significant complication.…”

Section: Introductionmentioning

confidence: 99%

A Contrast Frugal Approach to Transcatheter Aortic Valve Replacement in Chronic Kidney Disease: A Pilot Study

Bose¹,

Kanda²,

Roy³

et al. 2022

Cureus

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Background: Transcatheter aortic valve replacement (TAVR) is now regarded as a viable treatment option for all cases of severe aortic stenosis (AS). Acute kidney injury (AKI) is common and lowers the survival of patients after TAVR and iodine-based contrast-induced nephropathy (CIN) plays a significant adverse role in AKI. Therefore, in chronic kidney disease (CKD) patients requiring pre-operative evaluation for TAVR, the risk of CIN is of particular concern.Methods: It was a single-center study including eight CKD patients who underwent pre-operative evaluation for TAVR with minimized contrast exposure by means of pre-operative contrast-sparing evaluation and intra-operative contrast minimization. All patients had glomerular filtration rate (eGFR) calculated before TAVR and on a follow-up about one month and one year post-operatively to document the impact of this TAVR protocol on prognosis of kidney function in patients with advanced CKD.Results: New York Heart Association (NYHA) functional classification demonstrated significant improvement of symptomatology (p = 0.0001) by one-year post-TAVR. Patients' mean AS gradient was significantly improved (p =0.00004) after the TAVR procedure. No significant post-operative paravalvular aortic regurgitation was noted on follow up echocardiogram. eGFR data showed mean eGFR for the group was slightly better (27.38 ml/min/per 1.73 m 2 BSA vs. 30.38 ml/min/per 1.73 m 2 BSA) after TAVR. Conclusions: "Contrast frugal" approach is feasible and safe for pre-TAVR evaluation and the procedure itself. Our pilot study showed no significant paravalvular leak of the prosthetic valve following this proposed protocol. No statistically significant decrease in eGFR was noted on one-year follow-up.

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Section: Introductionmentioning

confidence: 99%