P1352Prediction of TAVR-related severe AV conduction disorders with a bedside and fast scoring system and Real time 3D TEE

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Background: Transcatheter aortic valve replacement (TAVR) is a valid treatment in inoperable and high risk patients (P) with severe aortic stenosis (AS). “De novo”, after TAVR, severe AV conduction disorders (AVCD), as left bundle branch block (LBBB) or Mobitz II second degree / third degree complete AV block are a major concern because high morbidity, stay length, definitive pacemaker and expenditure. We sought to improve the evaluation of valvular and paravalvular calcium burden using real time three-dimensional transoesophageal echocardiography (3D-TEE) proposing a novel semiquantitative scoring system to predict major AVCD. Methods: Longitudinal retrospective case-control study in a single tertiary care centre of patients submitted for TAVR (transfermoral) after Heart Team evaluation. Consecutive patients who shortly developed after TAVR major AVCD (new LBBB or high degree AV block with permanent ventricular pacing) were labelled as cases. Matched patients who did not developed major AVCD formed the control group (ratio 1.5/1). In all patients, 3D-TEE was accomplished into Cathlab before TAVR. Valvular and paravalvular calcium burden evaluated by means of a modified semiquantitative scoring system based on Colli and cols.

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