TY  - BOOK
AU  - Ben-Dor, Itsik
AU  - Buchanan, Kyle
AU  - Case, Brian
AU  - Dheendsa, Aaphtaab
AU  - Forrestal, Brian
AU  - Musallam, Anees
AU  - Rogers, Toby
AU  - Satler, Lowell F
AU  - Shea, Corey
AU  - Waksman, Ron
AU  - Yerasi, Charan
AU  - Zhang, Cheng
TI  - Impact of left ventricular outflow tract calcification on outcomes following transcatheter aortic valve replacement
SN  - 1878-0938
PY  - 2022///
KW  - *Aortic Valve Stenosis
KW  - *Heart Valve Prosthesis
KW  - *Transcatheter Aortic Valve Replacement
KW  - Aortic Valve Stenosis/dg [Diagnostic Imaging]
KW  - Aortic Valve Stenosis/su [Surgery]
KW  - Aortic Valve/dg [Diagnostic Imaging]
KW  - Aortic Valve/su [Surgery]
KW  - Humans
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Interventional Cardiology Fellowship
KW  - Journal Article
N2  - BACKGROUND: We aimed to determine left ventricular outflow tract (LVOT) calcification impact following transcatheter aortic valve replacement (TAVR) with contemporary transcatheter heart valves. Recent studies reported a higher rate of 2-year mortality with greater than moderate LVOT calcium, but they have not established a reliable and validated method to assess the degree of valve calcification and utilized first-generation valves for their analyses; CONCLUSIONS: TAVR performed in patients with calcified LVOT is safe, but LVOT calcification adversely impacts TAVR outcomes, with a higher PVL rate despite greater usage of BPD. Calcium quantification did not predict any PVL degree post-TAVR. Copyright (c) 2021. Published by Elsevier Inc; MATERIALS/METHODS: We conducted a retrospective analysis of patients who underwent TAVR at our institution from 2013 through 2017 with available valves. LVOT calcification quantification was assessed as a continuous variable; RESULTS: We included 273 patients: 179 had a non-calcified LVOT (NOLVOTCA) and 96 had a calcified LVOT (LVOTCA). Balloon post-dilatation (BPD) was utilized in 31.3% of LVOTCA vs. 19% of NOLVOTCA (p = 0.029). The Evolut R valve was used in 40.6% vs. 23.4% (p = 0.002), while the Sapien 3 was used in 59.4% vs. 76.6% (p = 0.004), for the LVOTCA and NOLVOTCA, respectively. Paravalvular leak (PVL) at hospital discharge was higher in LVOTCA (47.5%) versus NOLVOTCA (29.1%; p = 0.004). All-cause mortality (11.5% vs. 10.1%; p = 0.5) and need for permanent pacemaker implantation were similar between the groups. There was a positive trend between LVOT calcification volume and the probability of any PVL (OR 1.012; 95% CI, 0.99-1.02)
UR  - https://dx.doi.org/10.1016/j.carrev.2021.07.010
ER  -