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Short membranous septum length in bicuspid aortic valve stenosis increases the risk of conduction disturbances.
- Source :
-
Journal of cardiovascular computed tomography [J Cardiovasc Comput Tomogr] 2021 Jul-Aug; Vol. 15 (4), pp. 339-347. Date of Electronic Publication: 2020 Oct 29. - Publication Year :
- 2021
-
Abstract
- Background: Distinct anatomical features predispose bicuspid AS patients to conduction disturbances after TAVR. This study sought to evaluate whether the incidence of permanent pacemaker implantation (PPMI) and left bundle branch block (LBBB) in patients with bicuspid aortic stenosis (AS) following transcatheter aortic valve replacement (TAVR) is related to an anatomical association between bicuspid AS and short membranous septal (MS) length.<br />Methods: Sixty-seven consecutive patients with bicuspid AS from a Bicuspid AS TAVR multicenter registry and 67 propensity-matched patients with tricuspid AS underwent computed tomography before TAVR.<br />Results: MS length was significantly shorter in bicuspid AS compared with tricuspid AS (6.2 ± 2.5 mm vs. 8.4 ± 2.7 mm, respectively; p < 0.001). In patients with bicuspid AS, MS length and aortic valve calcification were the most powerful pre-procedural independent predictors of PPMI or LBBB (odds ratio [OR]: 1.38, 95% confidence interval [CI]: 1.15 to 1.55, p = 0.003 and OR: 1.92, 95% CI: 1.1 to 3.34, p = 0.022, respectively). When taking into account pre- and post-procedural parameters, aortic valve calcification and the difference between MS length and implantation depth were the most powerful independent predictors of PPMI or LBBB in patients with bicuspid AS (OR: 1.82, 95%: 1.1 to 3.1, p = 0.027; OR: 1.25, 95% CI: 1.10 to 1.38, p = 0.003).<br />Conclusion: MS length, which was significantly shorter in bicuspid AS compared with tricuspid AS, aortic valve calcification, and device implantation deeper than MS length predict PPMI or LBBB in bicuspid AS after TAVR.<br /> (Copyright © 2020 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aortic Valve diagnostic imaging
Aortic Valve surgery
Cardiac Pacing, Artificial
Constriction, Pathologic
Humans
Predictive Value of Tests
Risk Factors
Treatment Outcome
Aortic Valve Stenosis diagnostic imaging
Aortic Valve Stenosis surgery
Bicuspid Aortic Valve Disease
Heart Valve Prosthesis
Pacemaker, Artificial
Transcatheter Aortic Valve Replacement adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1876-861X
- Volume :
- 15
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular computed tomography
- Publication Type :
- Academic Journal
- Accession number :
- 33153946
- Full Text :
- https://doi.org/10.1016/j.jcct.2020.10.002