Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis Having Coronary Cusp Fusion versus Mixed Cusp Fusion Nonraphe Bicuspid Aortic Valve
Joint Authors
Lei, Wen-hua
Liao, Yan-biao
Wang, Zi-jie
Ou, Yuan-weixiang
Tsauo, Jiay-yu
Li, Yi-jian
Xiong, Tian-yuan
Zhao, Zhen-gang
Wei, Xin
Feng, Yuan
Chen, Mao
Meng, Wei
Source
Journal of Interventional Cardiology
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-11-03
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Objectives.
We aimed to assess the procedural and clinical results of transcatheter aortic valve replacement (TAVR) for nonraphe bicuspid aortic stenosis (AS) with coronary vs mixed cusp fusion.
Background.
It remains unclear whether cusp fusion morphology affects TAVR outcomes in patients with nonraphe bicuspid AS.
Methods.
This retrospective study enrolled consecutive patients with severe symptomatic AS and type-0 bicuspid aortic valve, who underwent TAVR at our institution between 2012 and 2017.
TAVR outcomes were defined based on the Valve Academic Research Consortium-2 recommendations.
Results.
Compared to patients with mixed cusp fusion (44/71), those with coronary cusp fusion (27/71) had a larger ellipticity index for the aortic annulus (21.9% ± 9.0% vs 15.6% ± 9.3%, p=0.007) and increased left ventricular outflow tract obstruction (31.1% ± 9.4% vs 26.9% ± 7.5%, p=0.04) but comparable rates of second valve implantation (15.9% vs 14.8%), mild paravalvular leakage (PVL, 38.5% vs 30.2%), permanent pacemaker implantation (PPM, 25.9% vs 15.9%), and 30-day mortality (7.4% vs 6.8%).
Use of a first-generation transcatheter heart valve was associated with higher risk for mild PVL (odds ratio (OR) = 4.37; 95% confidence interval (95% CI) = 1.14–16.75; p=0.03) but not PPM (OR = 0.77; 95% CI = 0.22–2.62; p=0.67), whereas a larger oversizing ratio tended to be associated with a higher PPM rate (OR = 1.49; 95% CI = 0.46–4.86; p=0.51) but lower incidence of mild PVL (OR = 0.51; 95% CI = 0.19–1.35; p=0.17).
Conclusions.
In AS patients with type-0 bicuspid valves, cusp fusion morphology does not affect the procedural or clinical results of TAVR.
Use of second-generation transcatheter heart valves may provide more favorable results in such patients.
This trial is registered with NCT01683474.
American Psychological Association (APA)
Lei, Wen-hua& Liao, Yan-biao& Wang, Zi-jie& Ou, Yuan-weixiang& Tsauo, Jiay-yu& Li, Yi-jian…[et al.]. 2019. Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis Having Coronary Cusp Fusion versus Mixed Cusp Fusion Nonraphe Bicuspid Aortic Valve. Journal of Interventional Cardiology،Vol. 2019, no. 2019, pp.1-7.
https://search.emarefa.net/detail/BIM-1181269
Modern Language Association (MLA)
Lei, Wen-hua…[et al.]. Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis Having Coronary Cusp Fusion versus Mixed Cusp Fusion Nonraphe Bicuspid Aortic Valve. Journal of Interventional Cardiology No. 2019 (2019), pp.1-7.
https://search.emarefa.net/detail/BIM-1181269
American Medical Association (AMA)
Lei, Wen-hua& Liao, Yan-biao& Wang, Zi-jie& Ou, Yuan-weixiang& Tsauo, Jiay-yu& Li, Yi-jian…[et al.]. Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis Having Coronary Cusp Fusion versus Mixed Cusp Fusion Nonraphe Bicuspid Aortic Valve. Journal of Interventional Cardiology. 2019. Vol. 2019, no. 2019, pp.1-7.
https://search.emarefa.net/detail/BIM-1181269
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1181269