000			04272nam a22006497a 4500
008			220221s20222022 xxu||||| |||| 00| 0 eng d
024			_a10.1016/j.amjcard.2021.12.019 [doi]
024			_aS0002-9149(21)01245-5 [pii]
040			_aOvid MEDLINE(R)
099			_a35067347
245			_aImpact of Left Ventricular Outflow Tract Calcium on Hemodynamics and Outcomes in Patients After Transcatheter Aortic Valve Implantation With a Contemporary Self-Expanding Valve.
251			_aAmerican Journal of Cardiology. 168:128-134, 2022 04 01.
252			_aAm J Cardiol. 168:128-134, 2022 04 01.
252			_zAm J Cardiol. 2022 Jan 20
253			_aThe American journal of cardiology
260			_c2022
260			_fFY2022
260			_p2022 Jan 20
265			_sppublish
266			_d2022-02-21
268			_aAmerican Journal of Cardiology. 2022 Jan 20
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aLeft ventricular outflow tract (LVOT) calcium remains a challenge for transcatheter aortic valve implantation (TAVI) and is associated with an increased risk of debris embolization, permanent pacemaker requirement, and annular rupture. We report the results of the (EPROMPT) CoreValve Evolut PRO Prospective Registry, which sought to evaluate the real-world performance of the CoreValve Evolut PRO transcatheter heart valve (THV) according to computed tomography-defined extent of LVOT calcium. The prospective, investigator-initiated, multicenter registry includes patients who underwent TAVI using the CoreValve Evolut PRO/PRO+ THV system. Analyzed patients were dichotomized on the basis of the severity of their LVOT calcium at baseline (none/mild vs moderate/severe). Patients were followed with 30-day clinical assessment and echocardiography. Of the 277 patients included, 177 had computed tomography-defined none/mild LVOT calcium (63.9%), and 100 had moderate/severe LVOT calcium (36.1%). Device success was similar in both cohorts (97.7% vs 95.0%; p = 0.217). Stroke rates were numerically higher in the moderate/severe LVOT calcium cohort (in-hospital and 30 day: 1.7% vs 4.0%; p = 0.240). Patients with none/mild LVOT calcium had higher rates of permanent pacemaker implantation (in-hospital: 21.5% vs 9.0%; p = 0.008 and 30-day: 22.0% vs 12.0%; p = 0.027). At 30 days, there were numerically higher rates of >mild paravalvular leak in patients with moderate/severe LVOT calcium (1.7% vs 4.0%; p = 0.240). Thirty-day mean gradients were similar (7.5 vs 7.6 mm Hg; p = 0.782). In conclusion, patients in the EPROMPT registry receiving the contemporary self-expanding CoreValve Evolut PRO/PRO+ THV demonstrated similar short-term outcomes and hemodynamics across the entire spectrum of LVOT calcium. Copyright (c) 2021. Published by Elsevier Inc.
546			_aEnglish
650			_a*Aortic Valve Stenosis
650			_a*Heart Valve Prosthesis
650			_a*Transcatheter Aortic Valve Replacement
650			_aAortic Valve Stenosis/co [Complications]
650			_aAortic Valve/dg [Diagnostic Imaging]
650			_aAortic Valve/su [Surgery]
650			_aCalcium
650			_aHeart Valve Prosthesis/ae [Adverse Effects]
650			_aHemodynamics
650			_aHumans
650			_aProsthesis Design
650			_aRetrospective Studies
650			_aTranscatheter Aortic Valve Replacement/mt [Methods]
650			_aTreatment Outcome
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Union Memorial Hospital
651			_aMedStar Washington Hospital Center
656			_aInterventional Cardiology Fellowship
657			_aJournal Article
700			_aAli, Syed
700			_aBen-Dor, Itsik
700			_aCase, Brian C
700			_aMedranda, Giorgio
700			_aRogers, Toby
700			_aSatler, Lowell F
700			_aWaksman, Ron
700			_aWang, John C
700			_aWeissman, Gaby
700			_aZhang, Cheng
790			_aAli SW, Ben-Dor I, Case BC, Medranda GA, Rogers T, Satler LF, Waksman R, Wang JC, Weissman G, Zhang C
856			_uhttps://dx.doi.org/10.1016/j.amjcard.2021.12.019 _zhttps://dx.doi.org/10.1016/j.amjcard.2021.12.019
942			_cART _dArticle
999			_c818 _d818