Timing of Onset and Outcome of New Conduction Abnormalities Following Transcatheter Aortic Valve Implantation: Role of Balloon Aortic Valvuloplasty

Campelo‐Parada, Francisco; Nombela‐Franco, Luis; Ureña, Marina; Regueiro, Ander; Jiménez‐Quevedo, Pilar; Trigo, María Del; Chamandi, Chekrallah; Rodríguez‐Gabella, Tania; Auffret, Vincent; Altisent, Omar Abdul‐Jawad; DeLarochellière, Robert; Paradis, Jean‐Michel; Dumont, Éric; Philippon, François; Pérez‐Castellano, Nicasio; Puri, Rishi; Macaya, Carlos; Rodés‐Cabau, Josep

doi:10.1016/j.rec.2017.04.010

Cited by 7 publications

(11 citation statements)

References 30 publications

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“…Ultimately, 23 studies were identified and provided data for the research analysis. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 An additional 30 studies are considered in Appendix E1 because of their limited sample size (<250 patients). The flowsheet for selection of included studies is represented in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

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One-year pacing dependency after pacemaker implantation in patients undergoing transcatheter aortic valve implantation: Systematic review and meta-analysis

et al. 2021

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Objectives: Atrioventricular conductions disturbances, requiring permanent pacemaker implantation (PPI), represent a potential complication after transcatheter aortic valve implantation (TAVI), However, little is known about the pacemaker dependency after PPI in this patient setting. This systematic review analyses the incidence of PPI, the short-term (1-year) pacing dependency, and predictors for such a state after TAVI.Methods: We performed a systematic search in PUBMED, EMBASE, and MEDLINE to identify potentially relevant literature investigating PPI requirement and dependency after TAVI. Study data, patients, and procedural characteristics were extracted. Odds ratio (OR) with 95% confidence intervals were extracted.Results: Data from 23 studies were obtained that included 18,610 patients. The crude incidence of PPI after TAVI was 17% (range, 8.8%-32%). PPI occurred at a median time of 3.2 days (range, 0-30 days). Pacing dependency at 1-year was 47.5% (range, 7%-89%). Self-expandable prosthesis (pooled OR was 2.14 [1.15-3.96]) and baseline right bundle branch block (pooled OR was 2.01 [1.06-3.83]) showed 2-fold greater risk to maintain PPI dependency at 1 year after TAVI.Conclusions: Although PPI represents a rather frequent event after TAVI, conduction disorders have a temporary nature in almost 50% of the cases with recovery and stabilization after discharge. Preoperative conduction abnormality and type of TAVI are associated with higher PPI dependency at short term. (JTCVS Open 2021;6:41-55)

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Section: Resultsmentioning

confidence: 99%

“…Nine studies didn't provide information about the timing of PPI. 9,[18][19][20][21]24,25,27,29 The overall incidence of PPI reached 17% of the TAVI patients, ranging from 8.8% to 32% of the cases.…”

Section: Ppi Detailsmentioning

confidence: 99%

One-year pacing dependency after pacemaker implantation in patients undergoing transcatheter aortic valve implantation: Systematic review and meta-analysis

et al. 2021

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“…As características do procedimento também estão implicadas na ocorrência de complicações de condução peri-TAVR. Vários relatos anteriores sugeriram índices mais altos de distúrbios de ritmo com pré-dilatação de válvula nativa e válvulas autoexpansíveis, 1,[17][18][19] embora isso não tivesse sido observado em nossa amostra, como sugerido por dados mais atuais. 20,21 Procedimentos válvula-em-válvula foram associados e menos distúrbios de condução de novo (RC = 0,19) e essa diferença não foi explicada por diferenças estatisticamente significativas na condução AV ou IV pré-TAVR, de acordo com dados publicados anteriormente.…”

Section: Pinto Et Al Dependência De Pacing a Longo-prazo Após Tavrunclassified

Dependência de Pacing a Longo-Prazo e Preditores de Implante de Pacemaker após Implante Percutâneo de Prótese Valvular Aórtica – 1 Ano de Seguimento

Pinto¹,

Proença²,

Carvalho³

et al. 2022

Arquivos Brasileiros De Cardiologia

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Fundamento: Os distúrbios de condução (DC) são a complicação mais frequente após a substituição da válvula aórtica transcateter (TAVR) e ainda não há consenso sobre seu tratamento. Objetivo: Avaliar novos DC e implante de marca-passo definitivo (MPD) após a TAVR e avaliar a porcentagem de estimulação ventricular (EV) até 1 ano de acompanhamento. Métodos: Pacientes submetidos a TAVR de outubro de 2014 a novembro de 2019 foram cadastrados; pacientes com MPD anterior foram excluídos. Dados clínicos, do procedimento, do ECG e do MPD foram coletados até 1 ano após o implante. O nível de significância adotado para a análise estatística foi 0,05%. Resultados: Um total de 340 indivíduos foram submetidos a TAVR. O DC mais comum foi bloqueio de ramo esquerdo novo (BRE; 32,2%), sendo que 56% destes foram resolvidos após 6 meses. O bloqueio do ramo direito (BRD) foi o maior fator de risco para bloqueio atrioventricular avançado (BAV) [RC=8,46; p<0,001] e implante de MPD [RC=5,18; p<0,001], seguido de BAV de baixo grau prévio [RC=2,25; p=0,016 para implante de MPD]. Em relação às características do procedimento, válvulas de gerações mais recentes e procedimentos de válvula-em-válvula foram associados a menos DC. No total, 18,5% dos pacientes tiveram MPD implantado após a TAVR. Na primeira avaliação do MPD, pacientes com BAV avançado tinham uma porcentagem mediana de EV de 80%, e, após um ano, de 83%. Em relação aos pacientes com BRE e BAV de baixo grau, a EV mediana foi mais baixa (6% na primeira avaliação, p=0,036; 2% após um ano, p = 0,065). Conclusão: O BRE foi o DC mais frequente após a TAVR, com mais da metade dos casos se resolvendo nos primeiros 6 meses. O BRD foi o principal fator de risco para BAV avançado e implante de MPD. O BAV avançado foi associado a uma porcentagem mais alta de EV no acompanhamento de 1 ano.

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“…Latest-generation TAVR devices have been associated with higher incidence of cardiac conduction abnormalities (CCAs). Balloon aortic valvuloplasty is routinely employed before TAVR, helping facilitate easier deployment and minimize the likelihood of coronary occlusion but increases the risk of conduction abnormalities [16, 17] and may require concurrent PPI. Cases of left bundle branch block (LBBB) and total atrioventricular (AV) block have been repeatedly reported [16, 17, 18, 19].…”

Section: Common Complications Of Tavrmentioning

confidence: 99%

“…Balloon aortic valvuloplasty is routinely employed before TAVR, helping facilitate easier deployment and minimize the likelihood of coronary occlusion but increases the risk of conduction abnormalities [16, 17] and may require concurrent PPI. Cases of left bundle branch block (LBBB) and total atrioventricular (AV) block have been repeatedly reported [16, 17, 18, 19]. Because of the proximity of the AV-node, mechanical stress and injury exerted by the deployed stent on the aortic annulus may damage the bundle of His fibers and those forming the left branch [19].…”

Section: Common Complications Of Tavrmentioning

confidence: 99%

Principles of TAVR valve design, modelling, and testing

Rotman

Bianchi

Ghosh

et al. 2018

Expert Review of Medical Devices

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Introduction: Transcatheter aortic valve replacement (TAVR) has emerged as an effective minimally-invasive alternative to surgical valve replacement in medium- to high-risk, elderly patients with calcific aortic valve disease and severe aortic stenosis. The rapid growth of the TAVR devices market has led to a high variety of designs, each aiming to address persistent complications associated with TAVR valves that may hamper the anticipated expansion of TAVR utility. Areas Covered: Here we outline the challenges and the technical demands that TAVR devices need to address for achieving the desired expansion, and review design aspects of selected, latest generation, TAVR valves of both clinically-used and investigational devices. We further review in detail some of the up-to-date modeling and testing approaches for TAVR, both computationally and experimentally, and additionally discuss those as complementary approaches to the ISO 5840–3 standard. A comprehensive survey of the prior and up-to-date literature was conducted to cover the most pertaining issues and challenges that TAVR technology faces. Expert Commentary: The expansion of TAVR over SAVR and to new indications seems more promising than ever. With new challenges to come, new TAV design approaches, and materials used, are expected to emerge, and novel testing/modeling methods to be developed.

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Timing of Onset and Outcome of New Conduction Abnormalities Following Transcatheter Aortic Valve Implantation: Role of Balloon Aortic Valvuloplasty

Cited by 7 publications

References 30 publications

One-year pacing dependency after pacemaker implantation in patients undergoing transcatheter aortic valve implantation: Systematic review and meta-analysis

One-year pacing dependency after pacemaker implantation in patients undergoing transcatheter aortic valve implantation: Systematic review and meta-analysis

Dependência de Pacing a Longo-Prazo e Preditores de Implante de Pacemaker após Implante Percutâneo de Prótese Valvular Aórtica – 1 Ano de Seguimento

Principles of TAVR valve design, modelling, and testing

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