Procedural Results of Patients Undergoing Transcatheter Aortic Valve Implantation With Aortic Annuli Diameter ≥26 mm: insights from the German Aortic Valve Registry

被引：8

作者：

Piayda, Kerstin ^{[1
]}

Bauer, Timm ^{[2
]}

Beckmann, Andreas ^{[3
]}

Bekeredjian, Raffi ^{[4
]}

Bleiziffer, Sabine ^{[5
,6
]}

Ensminger, Stephan ^{[7
]}

Frerker, Christian ^{[8
,9
]}

Moellmann, Helge ^{[10
]}

Walther, Thomas ^{[11
,12
]}

Balaban, Uemniye ^{[12
,13
]}

Herrmann, Eva ^{[12
,13
]}

Hamm, Christian ^{[14
]}

Beyersdorf, Friedhelm ^{[15
]}

Lichtenberg, Artur ^{[16
]}

Zeus, Tobias ^{[1
]}

Mehdiani, Arash ^{[16
]}

机构：

[1] Sana Clin Offenbach, Div Cardiol Pulmonol & Vasc Med, Offenbach, Germany

[2] Sana Clin Offenbach, Dept Cardiol, Gen Internal Med, Intens Care, Offenbach, Germany

[3] German Soc Thorac & Cardiovasc Surg, Berlin, Germany

[4] Robert Bosch Krankenhaus, Dept Cardiol, Stuttgart, Germany

[5] Heart & Diabet Ctr NRW, Clin Thorac & Cardiovasc Surg, Bad Oeynhausen, Germany

[6] German Ctr Cardiovasc Res, Berlin, Germany

[7] Univ Lubeck, Dept Cardiac Surg, Lubeck, Germany

[8] Univ Klinikum Schleswig Holstein, Dept Cardiol Vasc Med & Intens Care, Lubeck, Germany

[9] German Ctr Cardiovasc Res DZHK, Partner Site Hamburg Kiel Lubeck, Hamburg, Germany

[10] St Johannes Hosp Dortmund, Dept Internal Med 1, Dortmund, Germany

[11] Univ Hosp Frankfurt, Dept Cardiothorac Surg, Frankfurt, Germany

[12] German Ctr Cardiovasc Res DZHK, Partner Site Rhine Main, Frankfurt, Germany

[13] Goethe Univ Frankfurt, Inst Biostat & Math Modelling, Frankfurt, Germany

[14] Kerckhoff Klin Bad Nauheim, Dept Cardiol, Bad Nauheim, Germany

[15] Univ Freiburg, Dept Cardiovasc Surg, Freiburg, Germany

[16] Heinrich Heine Univ Dusseldorf, Fac Med, Dept Cardiovasc Surg, Dusseldorf, Germany

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2022年 / 164卷

关键词：

VASCULAR COMPLICATIONS; REGURGITATION; REPLACEMENT; GUIDELINES; OUTCOMES; THERAPY; DEVICES; SYSTEM; IMPACT;

D O I：

10.1016/j.amjcard.2021.10.021

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Patients presenting with severe aortic stenosis and large aortic annuli are challenging to treat because of the size limitations of available transcatheter heart valves. In this study, we aimed to determine clinical and hemodynamic outcomes in patients presenting with large aortic annuli who underwent transcatheter aortic valve implantation (TAVI). Patients from the German Aortic Valve Registry who underwent TAVI either with the Edwards Sapien (ES) or Medtronic CoreValve (MCV) systems from 2011 to 2017 were included. They were further stratified into a large (aortic annulus diameter 26 to 29 mm for ES; 26 to 30 mm for MCV) and extra-large (aortic annulus diameter >29 mm for ES; >30 mm for MCV) group and analyzed using propensity score adjustment. Extra-large was set beyond the sizing limitations according to the manufacturer's instructions for use. Patients in the large (n = 5,628) and extra-large (n = 509) groups were predominantly male (large: 92.6% vs extra-large: 91.9%). The 30-day mortality was comparable (large: 3.9% vs extra-large: 5.0%, p = 0.458). Procedure duration (large: 78.9 minutes +/- 0.82 vs extra-large: 86.4 minutes +/- 1.9, p <0.001) was longer in the extra-large group. Likewise, vascular complications (large: 6.2% vs extra-large: 12%, p = 0.002) and the need for a permanent pacemaker implantation (large: 18.8% vs extra-large: 26.0%, p = 0.027) were more often present in the extra-large group. Aortic regurgitation >II after valve implantation was numerically higher (large: 3.0% vs extra-large: 5.3%, p = 0.082) in patients with extra-large anatomy. In conclusion, patients with large and extra-large aortic annulus diameters who underwent TAVI have comparable 30-day mortality. Beyond the recommended annu-lus range, there is a higher risk for vascular complications and permanent pacemaker implantation. (C) 2021 Elsevier Inc. All rights reserved.

引用

页码：111 / 117

页数：7

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