Author + information
- Mariama Akodad1,
- Benoit Lattuca2,
- Audrey Agullo3,
- Gregory Marin4,
- Hélène Vernhet5,
- Laurent Schmutz6,
- Guillaume Cayla7 and
- Florence Leclercq8
- 1Chu, Montpellier, France
- 2Caremeau, Nîmes, France
- 3Arnaud de Villeneuve, Montpellier, France
- 4Arnaud de Villeneuve Hospital, Montpellier, France
- 5Arnaud de Villeneuve hospital, Montpellier, France
- 6University Hospital Montpellier, CHU de Nîmes, Montpellier, France
- 7Department of Cardiology, CHU Nîmes, Université de Montpellier, Montpellier, France
- 8University hospital montpellier, Montpellier, France
Calcium score (CS) is a recognized prognostic factor after TAVI performed with first-generation prosthesis but few data are available concerning new generation valves. Therefore, our aim was to determine if CS remains a prognostic factor after Sapien 3 and Evolut R valves implantation.
Agatston CS was evaluated on multislice computed tomography before TAVI in 346 patients implanted with Sapien XT (n=61), Corevalve (n=57) devices, (group 1, n=118), and with new generation Sapien 3 (n=147), Evolut R (n= 81) prosthesis, (group 2, n=228). Major adverse cardiovascular events and paravalvular leaks were evaluated at 1 -month.
The 2 groups were similar at baseline except for logistic Euroscore (20.1% in group 1 vs 15.0 % in group 2; p=0.001), chronic renal failure (44.1% vs 37.2 % respectively, p=0.007) and pre-procedural CS (4092 ±2176 vs 3682 ±2109 respectively, p=0.022). In group 1, 28 patients (23.7%) had adverse clinical events vs 21 (9.2%) in group 2 (p<0.01). Aortic regurgitation was more frequent in patient implanted with the first generation devices (figure 1). In multivariate analysis, a higher CS was predictive of adverse events in group 1 (5785 ± 3285 vs 3565±1331 p<0.0001) but not in group 2 (p=0.28). A higher CS was associated with AR in group 1 (6234±2711 vs 3429±1505; p<0.001) and in patients implanted with an Evolut R device from group 2 (4085 ±3645 vs 2551 ±1356; p=0.01).
CS appears as an important prognostic factor of major events after TAVI with first-generation valves but not with new generation devices. CS remains associated with AR only with new generation self-expandable Evolut R devices.
STRUCTURAL: Valvular Disease: Aortic