Author + information
- Bogdan Lucian Borz,
- Eric Durand,
- Camille Hauville,
- Christophe Tron,
- Matthieu Godin,
- Alexandre Canville,
- Fabrice Bauer,
- Pierre–Yves Litzler,
- Jean–Paul Bessou,
- Alain Cribier and
- Hélène Eltchaninoff
Aortic regurgitation (AR) is a frequent complication of transcatheter aortic valve replacement (TAVR). The association of more than mild AR with decreased mid–term survival is poorly explained. We sought to analyse the impact of AR on mortality after TAVR as a function of baseline NT–proBNP (NTBNP).
We included 222 consecutive patients from our single centre registry, all implanted with the Edwards Sapien and Sapien XT valves, via the transfemoral route. AR severity, graded from 1 to 4, was evaluated by transthoracic echocardiography. NTBNP was measured 24 hours before implantation and patients were divided in 2 groups according to the median NTBNP value.
Mean age was 83.6 ± 7 years and 131 (59%) were women. Patients with low NTBNP had higher left ventricular ejection fraction: 62 ± 11% vs. 49 ± 17%, p<0.001, less baseline AR ≥ 2: 26% vs. 44%, p=0.005, smaller telediastolic: 52 mm (48 – 56) vs. 57 mm (48 – 61), p = 0.002 and telesystolic diameters: 32 mm (28 – 36) vs. 39 mm (33 – 48), p < 0.001, but a similar mean aortic gradient: 45 ± 14 mmHg vs. 46 ± 20 mmHg, p = 0.75. Median NTBNP value was 2295 pg/ml. After TAVR, AR ≥ 2 was observed in 27% and was significantly associated with increased 1–year mortality only in the low NTBNP group (Figure).
Aortic regurgitation grade ≥ 2 after TAVR was associated with increased 1–year mortality only in patients with low baseline NTBNP. Our data suggest that the impact of AR after TAVR is absent in patients with remodelled ventricles and more severe baseline AR.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: TAVR I: Predictors of TAVR Outcomes Including LVEF, Contractile Reserve, BNP, Pulmonary HTN, CA 125, and Fever
Abstract Category: 32. Valvular Heart Disease: Therapy
Presentation Number: 1156M–87
- 2013 American College of Cardiology Foundation