000			04332nam a22006017a 4500
008			230411s20232023 xxu||||| |||| 00| 0 eng d
022			_a1936-8798
024			_a10.1016/j.jcin.2022.11.018 [doi]
024			_aNIHMS1859160 [mid]
024			_aPMC9991077 [pmc]
024			_aS1936-8798(22)02219-1 [pii]
040			_aOvid MEDLINE(R)
099			_a36858660
245			_aCoronary Obstruction From TAVR in Native Aortic Stenosis: Development and Validation of Multivariate Prediction Model.
251			_aJacc: Cardiovascular Interventions. 16(4):415-425, 2023 02 27.
252			_aJACC Cardiovasc Interv. 16(4):415-425, 2023 02 27.
253			_aJACC. Cardiovascular interventions
260			_c2023
260			_fFY2023
260			_p2023 02 27
265			_sppublish
265			_tMEDLINE
266			_d2023-04-11
501			_aAvailable online through MWHC library: 2008 - present
520			_aBACKGROUND: Transcatheter aortic valve replacement (TAVR)-related coronary artery obstruction prediction remains unsatisfactory despite high mortality and novel preventive therapies.
520			_aCONCLUSIONS: A novel computed tomography-based multivariate prediction model that can be implemented routinely in real-world practice predicted coronary artery obstruction from TAVR in native aortic stenosis. Copyright © 2023 American College of Cardiology Foundation. All rights reserved.
520			_aMETHODS: Preprocedure computed tomography and fluoroscopy images of patients in whom TAVR caused coronary artery obstruction were collected. Central laboratories made measurements, which were compared with unobstructed patients from a single-center database. A multivariate model was developed and validated against a 1:1 propensity-matched subselection of the unobstructed cohort.
520			_aOBJECTIVES: This study sought to develop a predictive model for TAVR-related coronary obstruction in native aortic stenosis.
520			_aRESULTS: Sixty patients with angiographically confirmed coronary obstruction and 1,381 without obstruction were included. In-hospital death was higher in the obstruction cohort (26.7% vs 0.7%; P < 0.001). Annular area and perimeter, coronary height, sinus width, and sinotubular junction height and width were all significantly smaller in the obstructed cohort. Obstruction was most common on the left side (78.3%) and at the level of the coronary artery ostium (92.1%). Coronary artery height and sinus width, but not annulus area, were significant risk factors for obstruction by logistic regression but performed poorly in predicting obstruction. The new multivariate model (coronary obstruction IF cusp height > coronary height, AND virtual valve-to-coronary distance <=4 mm OR culprit leaflet calcium volume >600 mm3) performed well, with an area under the curve of 0.93 (sensitivity = 0.93, specificity = 0.84) for the left coronary artery and 0.94 (sensitivity = 0.92, specificity = 0.96) for the right.
546			_aEnglish
650			_a*Aortic Valve Stenosis
650			_a*Coronary Occlusion
650			_a*Transcatheter Aortic Valve Replacement
650			_aHeart
650			_aHospital Mortality
650			_aHumans
650			_aTreatment Outcome
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
657			_aResearch Support, N.I.H., Intramural
657			_aResearch Support, Non-U.S. Gov't
700			_aBen-Dor, Itsik _bMHVI
700			_aKhan, Jaffar M _bMHVI
700			_aRogers, Toby _bMHVI
700			_aShults, Christian _bMHVI
700			_aTorguson, Rebecca _bMHVI
700			_aWaksman, Ron _bMHVI
700			_aWeissman, Gaby _bMHVI
700			_aZhang, Cheng _bMHVI
790			_aKhan JM, Kamioka N, Lisko JC, Perdoncin E, Zhang C, Maini A, Chen M, Li Y, Ludwig S, Westermann D, Amat Santos IJ, Kalinczuk L, Sinning JM, Kawaguchi T, Fuku Y, Cheema AN, Felix-Oliveira A, Yamamoto M, Kagase A, Codner P, Valle RD, Iyer VS, Kim HS, Lin MS, Maini B, Rodriguez R, Montorfano M, Ancona MB, Tada N, Miyasaka M, Ahmad H, Ruggiero NJ, Torguson R, Ben-Dor I, Shults CC, Weissman G, Lederman RJ, Greenbaum AB, Babaliaros VC, Waksman R, Rogers T
856			_uhttps://dx.doi.org/10.1016/j.jcin.2022.11.018 _zhttps://dx.doi.org/10.1016/j.jcin.2022.11.018
942			_cART _dArticle
999			_c11667 _d11667