Author + information
- Fernando Ramirez Del Val,
- Edward Carreras,
- Ahmed Kolkailah,
- Ritam Chowdhury,
- Siobhan McGurk,
- Jiyae Lee,
- Prem Shekar,
- Charles Nyman,
- Piotr Sobieszczyk,
- Marc Pelletier,
- Tsuyoshi Kaneko and
- Douglas Shook
Background: Decreased rate of permanent pacemaker (PPM) has been linked to a target aortic implantation depth (AID) above 0.70, following transcatheter aortic valve replacement (TAVR) with SAPIEN 3 valve (S3). We hypothesized that higher AID (>0.85) would lower the rate of PPM implantation.
Methods: A total of 127 patients underwent TAVR with S3. AID was defined as the proportion of the valve frame above the aortic annulus in post-deployment aortogram (Figure). Target AID (> 0.70) was achieved in 113/127 (89%) patients. Cases were stratified as high depth (HD> 0.85 AID) 33/127 (26%) or standard depth (SD<0.85 AID) 94/127 (74%).
Results: Mean age was 82±8 years, 61/127 (48%) were females and mean STS-PROM was 6.4±3.5. Preoperative right bundle branch block (RBBB) was present in 12/94 (13%) SD and 6/33 (18%) HD patients (p=0.56). There were no significant differences in hospital mortality, (3/94:3.2% for SD vs. 0/33 for HD patients), median length of stay (HD 2 days vs. SD 3 days) or moderate PVL (3/94:3.2% SD vs. 0/33 HD), (all p>0.41). The incidence of new PPM did not differ between the two groups (4/33 (12%) in the HD vs. 12/94(13%) in the SD, p=1.0). Mean AID was similar for patients with PPM implantation (0.78±0.06) and those without (0.80±0.08), (p=0.52). Preoperative RBBB was significantly associated with PPM implantation (OR: 10.1, p=0.002).
Conclusions: In TAVR with S3, higher AID (>0.85) was not associated with a lower PPM implantation rate. Prior RBBB was the only independent risk factor for new PPM implantation.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: TAVR 3
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1243-196
- 2017 American College of Cardiology Foundation