P5464Risk of major AV conduction disturbances after TAVR attributable to aortic calcium burden

Le résumé fourni par la source

Background: After transaortic valve replacement (TAVR), permanent LBBB or advanced/complete AV block are major concerns. Trends in epidemiology, procedure and morpho-anatomic landmarks in severe AV conduction disorders (AVCD) after TAVR are scarce. Methods: Cross sectional, retrospective and case-controls subanalysis of a cohort of patients (P) with severe aortic stenosis and submitted to Heart Team driven TAVR program in a single tertiary care center. Temporal cut-point accounts from 2009–2012 (P1) and 2013–2017 (P2). Main epidemiological, procedural variables and echocardiographic morpho-anatomic landmarks, including aortic calcium burden using a validated echo-score (from 3 to 11) were analyzed. Results: A transfemoral TAVR was performed in 338 consecutive P. There were not differences in success rate in P1 and P2 (96% vs. 94%; p=NS), but a trend for higher severe AVCD (17% vs. 25%; p=0.08). Concerning outcomes, severe AVCD related with self-expanding TAVR decreased over time (50% vs. 31%; p<0,01) and also post-TAVR “ballooning” (75% vs. 25%; p<0.05) and observed TAVR oversizing (Table). Aortic calcium burden was superior both in P1 and P2 in severe AVCD patients (p<0.01 and p<0.0001). In addition, aortic valve calcium burden increased up to 16,6% from P1 to P2 (p=0.04) parallel to the higher incidence of AVCD over time.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.