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Impact of device landing zone calcification patterns on paravalvular regurgitation after transcatheter aortic valve replacement with different next-generation devices

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Impact of device landing zone calcification patterns on paravalvular regurgitation after transcatheter aortic valve replacement with different next-generation devices. / Mauri, Victor; Frohn, Thomas; Deuschl, Florian; Mohemed, Kawa; Kuhr, Kathrin; Reimann, Andreas; Körber, Maria Isabel; Schofer, Niklas; Adam, Matti; Friedrichs, Kai; Kuhn, Elmar W; Scholtz, Smita; Rudolph, Volker; Wahlers, Thorsten C W; Baldus, Stephan; Mader, Navid; Schäfer, Ulrich; Rudolph, Tanja K.

In: OPEN HEART, Vol. 7, No. 1, e001164, 10.05.2020.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Mauri, V, Frohn, T, Deuschl, F, Mohemed, K, Kuhr, K, Reimann, A, Körber, MI, Schofer, N, Adam, M, Friedrichs, K, Kuhn, EW, Scholtz, S, Rudolph, V, Wahlers, TCW, Baldus, S, Mader, N, Schäfer, U & Rudolph, TK 2020, 'Impact of device landing zone calcification patterns on paravalvular regurgitation after transcatheter aortic valve replacement with different next-generation devices', OPEN HEART, vol. 7, no. 1, e001164. https://doi.org/10.1136/openhrt-2019-001164

APA

Mauri, V., Frohn, T., Deuschl, F., Mohemed, K., Kuhr, K., Reimann, A., Körber, M. I., Schofer, N., Adam, M., Friedrichs, K., Kuhn, E. W., Scholtz, S., Rudolph, V., Wahlers, T. C. W., Baldus, S., Mader, N., Schäfer, U., & Rudolph, T. K. (2020). Impact of device landing zone calcification patterns on paravalvular regurgitation after transcatheter aortic valve replacement with different next-generation devices. OPEN HEART, 7(1), [e001164]. https://doi.org/10.1136/openhrt-2019-001164

Vancouver

Mauri V, Frohn T, Deuschl F, Mohemed K, Kuhr K, Reimann A et al. Impact of device landing zone calcification patterns on paravalvular regurgitation after transcatheter aortic valve replacement with different next-generation devices. OPEN HEART. 2020 May 10;7(1). e001164. https://doi.org/10.1136/openhrt-2019-001164

Bibtex

@article{e7a71497233d4539bbe699e5076a3513,
title = "Impact of device landing zone calcification patterns on paravalvular regurgitation after transcatheter aortic valve replacement with different next-generation devices",
abstract = "OBJECTIVE: Residual paravalvular regurgitation (PVR) has been associated to adverse outcomes after transcatheter aortic valve replacement (TAVR). This study sought to evaluate the impact of device landing zone (DLZ) calcification on residual PVR after TAVR with different next-generation transcatheter heart valves.METHODS: 642 patients underwent TAVR with a SAPIEN 3 (S3; n=292), ACURATE neo (NEO; n=166), Evolut R (ER; n=132) or Lotus (n=52). Extent, location and asymmetry of DLZ calcification were assessed from contrast-enhanced CT imaging and correlated to PVR at discharge.RESULTS: PVR was ≥moderate in 0.7% of S3 patients, 9.6% of NEO patients, 9.8% of ER patients and 0% of Lotus patients (p<0.001), and these differences remained after matching for total DLZ calcium volume. The amount of DLZ calcium was significantly related to the degree of PVR in patients treated with S3 (p=0.045), NEO (p=0.004) and ER (p<0.001), but not in Lotus patients (p=0.698). The incidence of PVR ≥moderate increased significantly over the tertiles of DLZ calcium volume (p=0.046). On multivariable analysis, calcification of the aortic valve cusps, LVOT calcification and the use of self-expanding transcatheter aortic valve implantation (TAVI) prostheses emerged as predictors of PVR.CONCLUSIONS: The susceptibility to PVR depending on the amount of calcium was mainly observed in self-expanding TAVI prostheses. Thus, DLZ calcification is an important factor to be considered in prosthesis selection for each individual patient, keeping in mind the trade-off between PVR reduction, risk of new pacemaker implantation and unfavourable valve ha emodynamics.",
keywords = "Aged, Aged, 80 and over, Aortic Valve/diagnostic imaging, Aortic Valve Insufficiency/diagnostic imaging, Aortic Valve Stenosis/diagnostic imaging, Calcinosis/diagnostic imaging, Female, Germany, Heart Valve Prosthesis, Hemodynamics, Humans, Male, Prosthesis Design, Recovery of Function, Retrospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Transcatheter Aortic Valve Replacement/adverse effects, Treatment Outcome",
author = "Victor Mauri and Thomas Frohn and Florian Deuschl and Kawa Mohemed and Kathrin Kuhr and Andreas Reimann and K{\"o}rber, {Maria Isabel} and Niklas Schofer and Matti Adam and Kai Friedrichs and Kuhn, {Elmar W} and Smita Scholtz and Volker Rudolph and Wahlers, {Thorsten C W} and Stephan Baldus and Navid Mader and Ulrich Sch{\"a}fer and Rudolph, {Tanja K}",
note = "{\textcopyright} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2020",
month = may,
day = "10",
doi = "10.1136/openhrt-2019-001164",
language = "English",
volume = "7",
journal = "OPEN HEART",
issn = "2053-3624",
publisher = "BMJ PUBLISHING GROUP",
number = "1",

}

RIS

TY - JOUR

T1 - Impact of device landing zone calcification patterns on paravalvular regurgitation after transcatheter aortic valve replacement with different next-generation devices

AU - Mauri, Victor

AU - Frohn, Thomas

AU - Deuschl, Florian

AU - Mohemed, Kawa

AU - Kuhr, Kathrin

AU - Reimann, Andreas

AU - Körber, Maria Isabel

AU - Schofer, Niklas

AU - Adam, Matti

AU - Friedrichs, Kai

AU - Kuhn, Elmar W

AU - Scholtz, Smita

AU - Rudolph, Volker

AU - Wahlers, Thorsten C W

AU - Baldus, Stephan

AU - Mader, Navid

AU - Schäfer, Ulrich

AU - Rudolph, Tanja K

N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2020/5/10

Y1 - 2020/5/10

N2 - OBJECTIVE: Residual paravalvular regurgitation (PVR) has been associated to adverse outcomes after transcatheter aortic valve replacement (TAVR). This study sought to evaluate the impact of device landing zone (DLZ) calcification on residual PVR after TAVR with different next-generation transcatheter heart valves.METHODS: 642 patients underwent TAVR with a SAPIEN 3 (S3; n=292), ACURATE neo (NEO; n=166), Evolut R (ER; n=132) or Lotus (n=52). Extent, location and asymmetry of DLZ calcification were assessed from contrast-enhanced CT imaging and correlated to PVR at discharge.RESULTS: PVR was ≥moderate in 0.7% of S3 patients, 9.6% of NEO patients, 9.8% of ER patients and 0% of Lotus patients (p<0.001), and these differences remained after matching for total DLZ calcium volume. The amount of DLZ calcium was significantly related to the degree of PVR in patients treated with S3 (p=0.045), NEO (p=0.004) and ER (p<0.001), but not in Lotus patients (p=0.698). The incidence of PVR ≥moderate increased significantly over the tertiles of DLZ calcium volume (p=0.046). On multivariable analysis, calcification of the aortic valve cusps, LVOT calcification and the use of self-expanding transcatheter aortic valve implantation (TAVI) prostheses emerged as predictors of PVR.CONCLUSIONS: The susceptibility to PVR depending on the amount of calcium was mainly observed in self-expanding TAVI prostheses. Thus, DLZ calcification is an important factor to be considered in prosthesis selection for each individual patient, keeping in mind the trade-off between PVR reduction, risk of new pacemaker implantation and unfavourable valve ha emodynamics.

AB - OBJECTIVE: Residual paravalvular regurgitation (PVR) has been associated to adverse outcomes after transcatheter aortic valve replacement (TAVR). This study sought to evaluate the impact of device landing zone (DLZ) calcification on residual PVR after TAVR with different next-generation transcatheter heart valves.METHODS: 642 patients underwent TAVR with a SAPIEN 3 (S3; n=292), ACURATE neo (NEO; n=166), Evolut R (ER; n=132) or Lotus (n=52). Extent, location and asymmetry of DLZ calcification were assessed from contrast-enhanced CT imaging and correlated to PVR at discharge.RESULTS: PVR was ≥moderate in 0.7% of S3 patients, 9.6% of NEO patients, 9.8% of ER patients and 0% of Lotus patients (p<0.001), and these differences remained after matching for total DLZ calcium volume. The amount of DLZ calcium was significantly related to the degree of PVR in patients treated with S3 (p=0.045), NEO (p=0.004) and ER (p<0.001), but not in Lotus patients (p=0.698). The incidence of PVR ≥moderate increased significantly over the tertiles of DLZ calcium volume (p=0.046). On multivariable analysis, calcification of the aortic valve cusps, LVOT calcification and the use of self-expanding transcatheter aortic valve implantation (TAVI) prostheses emerged as predictors of PVR.CONCLUSIONS: The susceptibility to PVR depending on the amount of calcium was mainly observed in self-expanding TAVI prostheses. Thus, DLZ calcification is an important factor to be considered in prosthesis selection for each individual patient, keeping in mind the trade-off between PVR reduction, risk of new pacemaker implantation and unfavourable valve ha emodynamics.

KW - Aged

KW - Aged, 80 and over

KW - Aortic Valve/diagnostic imaging

KW - Aortic Valve Insufficiency/diagnostic imaging

KW - Aortic Valve Stenosis/diagnostic imaging

KW - Calcinosis/diagnostic imaging

KW - Female

KW - Germany

KW - Heart Valve Prosthesis

KW - Hemodynamics

KW - Humans

KW - Male

KW - Prosthesis Design

KW - Recovery of Function

KW - Retrospective Studies

KW - Risk Assessment

KW - Risk Factors

KW - Severity of Illness Index

KW - Time Factors

KW - Transcatheter Aortic Valve Replacement/adverse effects

KW - Treatment Outcome

U2 - 10.1136/openhrt-2019-001164

DO - 10.1136/openhrt-2019-001164

M3 - SCORING: Journal article

C2 - 32393655

VL - 7

JO - OPEN HEART

JF - OPEN HEART

SN - 2053-3624

IS - 1

M1 - e001164

ER -