The interaction of de novo and pre-existing aortic regurgitation after TAVI: Insights from a new quantitative aortographic technique
Aims: The aim of this study was to evaluate the intermediate-term clinical impact of aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) using a novel quantitative angiographic method taking into account the influence of pre-existing AR.
Methods and results: AR after TAVI was quantified in 338 patients and the influence on intermediate-term all-cause mortality was evaluated. In 228 aortograms, AR was quantitated using a dedicated videodensitometric method focused in the left ventricular outflow tract (LVOT-AR). Patients with LVOT-AR >0.17 had a significantly increased all-cause mortality at three years, compared with patients who had LVOT-AR ≤0.17. Taking the influence of pre-existing AR into account, patients with post-procedural LVOT-AR >0.17 and ≤mild pre-existing AR had a significantly increased mortality at two years, compared to patients with LVOT-AR >0.17 and >mild pre-existing AR. In those with >mild pre-existing AR, post-TAVI LVOT-AR >0.17 was not associated with increased mortality.
Conclusions: AR after TAVI could be quantitated utilising LVOT-AR. The cut-point of >0.17 indicates a significant AR pertaining to increased intermediate-term mortality, especially in those with no significant pre-existing AR.
|Persistent URL||dx.doi.org/10.4244/EIJ-D-16-00647, hdl.handle.net/1765/100232|
Tateishi, H, Abdelghani, M, Cavalcante, R, Miyazaki, Y, Campos, C.A.M, Collet, C, … De Brito Jr., F.S. (2017). The interaction of de novo and pre-existing aortic regurgitation after TAVI: Insights from a new quantitative aortographic technique. EuroIntervention, 13(1), 60–68. doi:10.4244/EIJ-D-16-00647