1. Impact of aortic valve calcification severity on device success after transcatheter aortic valve replacement
- Author
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Bertrand Marcheix, Vincent Bataille, Frédéric Bouisset, Hervé Rousseau, Thibault Lhermusier, Marie-Agnès Marachet, Antoine Petermann, Nicolas Boudou, Didier Carrié, Michel Galinier, Jeremy Larroche, Olivier Lairez, Yoan Lavie-Badie, Thomas Chollet, and Loïc Panh
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Aortic Valve Insufficiency ,Subgroup analysis ,030204 cardiovascular system & hematology ,Prosthesis Design ,Risk Assessment ,Severity of Illness Index ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,Valve replacement ,Risk Factors ,Internal medicine ,medicine.artery ,Hounsfield scale ,Multidetector Computed Tomography ,Ascending aorta ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Cardiac skeleton ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Calcinosis ,Aortic Valve Stenosis ,medicine.disease ,Echocardiography, Doppler ,Stenosis ,Treatment Outcome ,Aortic Valve ,Heart Valve Prosthesis ,Cardiology ,Female ,Aortic valve calcification ,Cardiology and Cardiovascular Medicine ,business ,Mace - Abstract
Aortic valvular calcium score (AVCS) can identify severe aortic stenosis (AS) and provide powerful prognostic information. In severe and symptomatic AS, patients can be referred for a transcatheter aortic valve replacement (TAVR). The aim of this study was to determine whether AVCS, measured on the preoperative contrast enhanced multislice computed tomography (MSCT), is associated with device success (DS), major adverse cardiac events (MACEs) and paravalvular leak (PVL) after TAVR. Three hundred and fifty-two consecutive patients who underwent TAVR with a preoperative standardised contrast enhanced MSCT were included in the study. Valvular calcification detection was defined by adding + 100 Hounsfield Unit (HU) to mean HU determined by a region of interest placed in the contrast enhanced ascending aorta. AVCS was then indexed to the aortic annulus surface (AVCSi). Endpoints were DS and 30-day MACE according to Valve Academic Research Consortium-2 consensus document, and moderate to severe PVL. DS was obtained for 305 patients. In multivariate analysis, AVCSi was negatively and independently associated with DS: OR = 0.99, 95% CI 0.99–0.99, p = 0.03. In the subgroup analysis, this association was particularly relevant with self-expanding prostheses [n = 151 (43%), p = 0.018] and in the cases of asymmetric calcium valvular distribution [n = 283 (80%), p 0.002]. There was no association between MACE and AVCS (p = 0.953) and AVCSi (p = 0.757). PVL was positively associated with AVCS (p
- Published
- 2020
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