Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis
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Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis. / Bugani, Giulia; Pagnesi, Matteo; Tchetchè, Didier; Kim, Won Keun; Khokhar, Arif; Sinning, Jean Malte; Landes, Uri; Kornowski, Ran; Codner, Pablo; De Backer, Ole; Nickenig, Georg; Ielasi, Alfonso; De Biase, Chiara; Søndergaard, Lars; De Marco, Federico; Ancona, Marco; Montorfano, Matteo; Regazzoli, Damiano; Stefanini, Giulio; Toggweiler, Stefan; Tamburino, Corrado; Immè, Sebastiano; Tarantini, Giuseppe; Sievert, Horst; Schäfer, Ulrich; Kempfert, Jörg; Wöehrle, Jochen; Tespili, Maurizio; Laricchia, Alessandra; Latib, Azeem; Giannini, Francesco; Colombo, Antonio; Mangieri, Antonio.
I: Clinical Research in Cardiology, Bind 110, Nr. 5, 2021, s. 667-675.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis
AU - Bugani, Giulia
AU - Pagnesi, Matteo
AU - Tchetchè, Didier
AU - Kim, Won Keun
AU - Khokhar, Arif
AU - Sinning, Jean Malte
AU - Landes, Uri
AU - Kornowski, Ran
AU - Codner, Pablo
AU - De Backer, Ole
AU - Nickenig, Georg
AU - Ielasi, Alfonso
AU - De Biase, Chiara
AU - Søndergaard, Lars
AU - De Marco, Federico
AU - Ancona, Marco
AU - Montorfano, Matteo
AU - Regazzoli, Damiano
AU - Stefanini, Giulio
AU - Toggweiler, Stefan
AU - Tamburino, Corrado
AU - Immè, Sebastiano
AU - Tarantini, Giuseppe
AU - Sievert, Horst
AU - Schäfer, Ulrich
AU - Kempfert, Jörg
AU - Wöehrle, Jochen
AU - Tespili, Maurizio
AU - Laricchia, Alessandra
AU - Latib, Azeem
AU - Giannini, Francesco
AU - Colombo, Antonio
AU - Mangieri, Antonio
N1 - Publisher Copyright: © 2021, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021
Y1 - 2021
N2 - Objectives: To define the incidence of high residual gradient (HRG) after transcatheter aortic valve replacement (TAVR) in BAVs and their impact on short term outcome and 1-year mortality. Background: Transcatheter heart valves (THVs) offer good performance in tricuspid aortic valves with low rate of HRG. However, data regarding their performance in bicuspid aortic valves (BAV) are still lacking. Methods: The BEAT (Balloon vs Self-Expandable valve for the treatment of bicuspid Aortic valve sTenosis) registry included 353 consecutive patients who underwent TAVR (Evolut R/PRO or Sapien 3 valves) in BAV between June 2013 and October 2018. The primary endpoint was device unsuccess with post-procedural HRG (mean gradient ≥ 20 mmHg). The secondary endpoint was to identify the predictors of HRG following the procedure. Results: Twenty patients (5.6%) showed HRG after TAVR. Patients with HRG presented higher body mass index (BMI) (30.7 ± 9.3 vs. 25.9 ± 4.8; p < 0.0001) and higher baseline aortic mean gradients (57.6 ± 13.4 mmHg vs. 47.7 ± 16.6, p = 0.013) and more often presented with BAV of Sievers type 0 than patients without HRG. At multivariate analysis, BMI [odds ratio (OR) 1.12; 95% confidence interval (CI) 1.05–1.20, p = 0.001] and BAV type 0 (OR 11.31, 95% CI 3.45–37.06, p < 0.0001) were confirmed as independent predictors of high gradient. Conclusion: HRG following TAVR in BAVs is not negligible and is higher among patients with high BMI and with BAV 0 anatomy. Graphic abstract: [Figure not available: see fulltext.].
AB - Objectives: To define the incidence of high residual gradient (HRG) after transcatheter aortic valve replacement (TAVR) in BAVs and their impact on short term outcome and 1-year mortality. Background: Transcatheter heart valves (THVs) offer good performance in tricuspid aortic valves with low rate of HRG. However, data regarding their performance in bicuspid aortic valves (BAV) are still lacking. Methods: The BEAT (Balloon vs Self-Expandable valve for the treatment of bicuspid Aortic valve sTenosis) registry included 353 consecutive patients who underwent TAVR (Evolut R/PRO or Sapien 3 valves) in BAV between June 2013 and October 2018. The primary endpoint was device unsuccess with post-procedural HRG (mean gradient ≥ 20 mmHg). The secondary endpoint was to identify the predictors of HRG following the procedure. Results: Twenty patients (5.6%) showed HRG after TAVR. Patients with HRG presented higher body mass index (BMI) (30.7 ± 9.3 vs. 25.9 ± 4.8; p < 0.0001) and higher baseline aortic mean gradients (57.6 ± 13.4 mmHg vs. 47.7 ± 16.6, p = 0.013) and more often presented with BAV of Sievers type 0 than patients without HRG. At multivariate analysis, BMI [odds ratio (OR) 1.12; 95% confidence interval (CI) 1.05–1.20, p = 0.001] and BAV type 0 (OR 11.31, 95% CI 3.45–37.06, p < 0.0001) were confirmed as independent predictors of high gradient. Conclusion: HRG following TAVR in BAVs is not negligible and is higher among patients with high BMI and with BAV 0 anatomy. Graphic abstract: [Figure not available: see fulltext.].
KW - Balloon-expandable valve
KW - Bicuspid
KW - High residual gradient
KW - Self-expandable valve
KW - Transcatheter aortic valve implantation
U2 - 10.1007/s00392-020-01793-9
DO - 10.1007/s00392-020-01793-9
M3 - Journal article
C2 - 33389062
AN - SCOPUS:85098541534
VL - 110
SP - 667
EP - 675
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
SN - 1861-0684
IS - 5
ER -
ID: 304147078