Impact of left ventricular outflow tract calcification in patients undergoing transfemoral transcatheter aortic valve implantation
Standard
Impact of left ventricular outflow tract calcification in patients undergoing transfemoral transcatheter aortic valve implantation. / Waldschmidt, Lara; Goßling, Alina; Ludwig, Sebastian; Linder, Matthias; Voigtländer, Lisa; Grundmann, David; Bhadra, Oliver Daniel; Demal, Till Joscha; Schirmer, Johannes; Reichenspurner, Hermann; Blankenberg, Stefan; Westermann, Dirk; Seiffert, Moritz; Conradi, Lenard; Schofer, Niklas.
in: EUROINTERVENTION, Jahrgang 17, Nr. 17, 01.04.2022, S. e1417-e1424.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Impact of left ventricular outflow tract calcification in patients undergoing transfemoral transcatheter aortic valve implantation
AU - Waldschmidt, Lara
AU - Goßling, Alina
AU - Ludwig, Sebastian
AU - Linder, Matthias
AU - Voigtländer, Lisa
AU - Grundmann, David
AU - Bhadra, Oliver Daniel
AU - Demal, Till Joscha
AU - Schirmer, Johannes
AU - Reichenspurner, Hermann
AU - Blankenberg, Stefan
AU - Westermann, Dirk
AU - Seiffert, Moritz
AU - Conradi, Lenard
AU - Schofer, Niklas
PY - 2022/4/1
Y1 - 2022/4/1
N2 - BACKGROUND: Left ventricular outflow tract (LVOT) calcification is known to be associated with adverse outcomes after transcatheter aortic valve implantation (TAVI) in patients receiving first-generation transcatheter heart valves (THV).AIMS: The aim of the present study was to assess the prevalence of LVOT calcification as well as its impact on outcomes in a contemporary TAVI patient cohort.METHODS: This retrospective single-centre analysis includes 1,207 patients who underwent transfemoral TAVI between 2012 and 2018 and in whom adequate contrast-enhanced multislice computed tomgraphy (MSCT) imaging for quantification of LVOT calcification was available.RESULTS: Significant LVOT calcification, defined as >10 mm3, was present in 37.4% (n=451) of the patient cohort. After applying propensity score matching there was no difference between patients without (w/o; n=358) and with (w; n=358) significant LVOT calcification with respect to baseline clinical characteristics. At 30 days, the composite of all-cause mortality and non-disabling/disabling stroke occurred more often in patients w LVOT calcification compared to those w/o (4.6 vs 10.1%, p=0.008). Moreover, the composite VARC-3 endpoint of device success at 30 days was in favour of patients w/o LVOT calcification (82.2% vs 73.4%, p=0.007). According to Kaplan-Meier analysis, all-cause mortality one year after TAVI was higher in patients w vs w/o LVOT calcification (12.9 vs 21.4 %, p=0.004).CONCLUSIONS: In patients undergoing TAVI, the presence of significant LVOT calcification is common and associated with worse short-term clinical and functional outcomes as well as higher one-year mortality rates compared to patients w/o LVOT calcification.
AB - BACKGROUND: Left ventricular outflow tract (LVOT) calcification is known to be associated with adverse outcomes after transcatheter aortic valve implantation (TAVI) in patients receiving first-generation transcatheter heart valves (THV).AIMS: The aim of the present study was to assess the prevalence of LVOT calcification as well as its impact on outcomes in a contemporary TAVI patient cohort.METHODS: This retrospective single-centre analysis includes 1,207 patients who underwent transfemoral TAVI between 2012 and 2018 and in whom adequate contrast-enhanced multislice computed tomgraphy (MSCT) imaging for quantification of LVOT calcification was available.RESULTS: Significant LVOT calcification, defined as >10 mm3, was present in 37.4% (n=451) of the patient cohort. After applying propensity score matching there was no difference between patients without (w/o; n=358) and with (w; n=358) significant LVOT calcification with respect to baseline clinical characteristics. At 30 days, the composite of all-cause mortality and non-disabling/disabling stroke occurred more often in patients w LVOT calcification compared to those w/o (4.6 vs 10.1%, p=0.008). Moreover, the composite VARC-3 endpoint of device success at 30 days was in favour of patients w/o LVOT calcification (82.2% vs 73.4%, p=0.007). According to Kaplan-Meier analysis, all-cause mortality one year after TAVI was higher in patients w vs w/o LVOT calcification (12.9 vs 21.4 %, p=0.004).CONCLUSIONS: In patients undergoing TAVI, the presence of significant LVOT calcification is common and associated with worse short-term clinical and functional outcomes as well as higher one-year mortality rates compared to patients w/o LVOT calcification.
KW - Aortic Valve/diagnostic imaging
KW - Aortic Valve Stenosis
KW - Calcinosis/complications
KW - Heart Valve Prosthesis/adverse effects
KW - Humans
KW - Multidetector Computed Tomography
KW - Retrospective Studies
KW - Transcatheter Aortic Valve Replacement
KW - Treatment Outcome
U2 - 10.4244/EIJ-D-21-00464
DO - 10.4244/EIJ-D-21-00464
M3 - SCORING: Journal article
C2 - 34658340
VL - 17
SP - e1417-e1424
JO - EUROINTERVENTION
JF - EUROINTERVENTION
SN - 1774-024X
IS - 17
ER -