Implante alto de las válvulas autoexpandibles con la técnica de “Cusp-Overlap”, una estrategia para disminuir la necesidad de marcapasos en el implante percutáneo de válvula aórtica. Evolución a 30 días

Le résumé fourni par la source

Objective: The aim of this study was to analyze whether higher transcatheter aortic valve implantation with self-expandable valves using the right and left cusp overlap strategy decreases the need for permanent pacemaker.Methods: A total of 164 consecutive patients undergoing TAVI with self-expandable valves were analyzed: 101 (61.6%) implantedwith the conventional technique (CON) using the three-cusp coplanar view, and 63 (38.4%) using the right and left cusp overlap (COVL) technique. The primary endpoint (PEP) was the need for permanent pacemaker (PPM) at 30 days.Results: Mean age, prevalence of male gender, hypertension, prior coronary artery bypass graft surgery (CABG), and history of stroke, kidney function or hemodialysis was not different between groups. Patients in the COVL group had more diabetes,coronary percutaneous transluminal coronary angioplasty (PTCA) and prior infarct, and pre-TAVI PTCA was similar, with higher STS score (6.3±2.2 vs. 5.8±2.4; p=0.05). The presence of atrial fibrillation was greater in the COVL group, without differences in right or left bundle branch or atrioventricular block.There was no difference in aortic valve area, mean gradient and left ventricular ejection fraction.At 30 days, the need of PPM was significantly reduced with the COVL technique (6.3%% vs. 17.8%; p=0.03). No difference was observed in mortality, stroke, major bleeding, acute myocardial infarction or aortic regurgitation, and the presence of new-onset complete left bundle branch block was lower in the COVL group (4.8% vs. 12.9%; p=0.08).Conclusions: Use of the COVL technique, which allows higher self-expandable valve implantation during TAVI, was feasible and safe, decreasing the need for PPM without increasing complications. How to cite this article: Fava C, Caponi G, Valdivieso L, Lev G, Gamboa P, Fraguas H, et al. High Self-expandable Valve Implantation with the Cusp-Overlap Technique, a Strategy to Reduce the Need for Pacemaker inTranscatheter Aortic Valve Implantation. 30-day Outcome. Rev Argent Cardiol 2022;90:106-12. http://dx.doi.org/10.7775/rac.v90.i2.20481

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