Author + information
- Kentaro Hayashida,
- Erik Bouvier,
- Thierry Lefèvre,
- Bernard Chevalier,
- Thomas Hovasse,
- Mauro Romano,
- Philippe Garot,
- Yusuke Watanabe,
- Arnaud Farge,
- Patrick Donzeau–Gouge,
- Bertrand Cormier and
- Marie–Claude Morice
The purpose of this study was to elucidate impact of annulus ellipticity on clinical outcomes after transcatheter aortic valve implantation (TAVI).
Of 548 patients included in our TAVI database with either of the Edwards or CoreValve (October 2006 to June 2012), 305 consecutive patients undergoing pre–procedural multidetector computed tomography (MDCT) were analyzed. Ellipticity was defined as “long/short–axis MDCT–measured diameter ratio>1.20”. We compared clinical outcomes in patients with (n=155) vs. without (n=150) ellipticity.
Patients were 83.2±6.6 years old and EuroSCORE was 19.9±12.0%. The ellipticity group was similar to the non–ellipticity group except for coronary disease (49.0vs64.0%, P=0.01). Despite no significant difference in mean MDCT–measured diameter (23.7±2.1vs23.8±2.1mm, P=0.47), ellipticity was associated with decreased short–axis (21.3±2.0vs22.5±2.0mm, P<0.01) and increased long–axis diameter (27.0±2.5vs25.7±2.5mm, P<0.01) resulting in increased long/short–axis diameter ratio (1.27±0.07vs1.14±0.06mm, P<0.01). Ellipticity group tended to have increased incidence of bicuspid valve (12.3%vs6.0%, P=0.06). The CoreValve was used similarly (21.3vs22.0%, P=0.88). There was no significant difference in device success (94.2vs93.3%, P=0.76), risk of annulus rupture (1.3vs0.7%, P=0.51) or valve migration (0vs2.0%, P=0.12) between 2 groups. Post–procedural mean gradient (10.1±6.1vs9.7±3.7mmHg, P=0.52), aortic regurgitation ≥2/4 (15.5vs17.3%, P=0.66), 30–day mortality (5.8vs10.0%, P=0.17) and 30–day combined safety point (14.2vs14.7%, P=0.91) were also similar in both groups.
In patients with ellipticity, TAVI is associated with equally high rates of success, low complication rates, similar efficacy and acceptable outcomes as in non–ellipticity patients.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.–4:30 p.m.
Session Title: TAVR II: The Devil Is in the Details – Annular Sizing, Post Dilation, Acute Kidney Injury and Conduction Disease
Abstract Category: 32. Valvular Heart Disease: Therapy
Presentation Number: 1242M–85
- 2013 American College of Cardiology Foundation