RT Journal Article
T1 Incidence, Timing, and Predictors of Valve Hemodynamic Deterioration After Transcatheter Aortic Valve Replacement: Multicenter Registry.
A1 Del Trigo, Maria
A1 Muñoz-Garcia, Antonio J
A1 Wijeysundera, Harindra C
A1 Nombela-Franco, Luis
A1 Cheema, Asim N
A1 Gutierrez, Enrique
A1 Serra, Vicenç
A1 Kefer, Joelle
A1 Amat-Santos, Ignacio J
A1 Benitez, Luis M
A1 Mewa, Jumana
A1 Jiménez-Quevedo, Pilar
A1 Alnasser, Sami
A1 Garcia Del Blanco, Bruno
A1 Dager, Antonio
A1 Abdul-Jawad Altisent, Omar
A1 Puri, Rishi
A1 Campelo-Parada, Francisco
A1 Dahou, Abdellaziz
A1 Paradis, Jean-Michel
A1 Dumont, Eric
A1 Pibarot, Philippe
A1 Rodés-Cabau, Josep
K1 anticoagulation therapy
K1 transcatheter aortic valve replacement
K1 valve degeneration
K1 valve-in-valve
AB Scarce data exist on the incidence of and factors associated with valve hemodynamic deterioration (VHD) after transcatheter aortic valve replacement (TAVR). This study sought to determine the incidence, timing, and predictors of VHD in a large cohort of patients undergoing TAVR. This multicenter registry included 1,521 patients (48% male; 80 ± 7 years of age) who underwent TAVR. Mean echocardiographic follow-up was 20 ± 13 months (minimum: 6 months). Echocardiographic examinations were performed at discharge, at 6 to 12 months, and yearly thereafter. Annualized changes in mean gradient (mm Hg/year) were calculated by dividing the difference between the mean gradient at last follow-up and the gradient at discharge by the time between examinations. VHD was defined as a ≥10 mm Hg increase in transprosthetic mean gradient during follow-up compared with discharge assessment. The overall mean annualized rate of transprosthetic gradient progression during follow-up was 0.30 ± 4.99 mm Hg/year. A total of 68 patients met criteria of VHD (incidence: 4.5% during follow-up). The absence of anticoagulation therapy at hospital discharge (p = 0.002), a valve-in-valve (TAVR in a surgical valve) procedure (p = 0.032), the use of a 23-mm valve (p = 0.016), and a greater body mass index (p = 0.001) were independent predictors of VHD. There was a mild but significant increase in transvalvular gradients over time after TAVR. The lack of anticoagulation therapy, a valve-in-valve procedure, a greater body mass index, and the use of a 23-mm transcatheter valve were associated with higher rates of VHD post-TAVR. Further prospective studies are required to determine whether a specific antithrombotic therapy post-TAVR may reduce the risk of VHD.
YR 2016
FD 2016
LK http://hdl.handle.net/10668/9824
UL http://hdl.handle.net/10668/9824
LA en
DS RISalud
RD Apr 6, 2025