Self-expanding TAVI using the cusp overlap technique versus the traditional technique: electrocardiogram changes and 1-year cardiovascular outcomes.

Autor: Persia-Paulino YR; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain., Almendarez Lacayo M; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Grupo de Investigación de Patología Cardiaca, Instituto de Investigación del Principado de Asturias, Oviedo, Asturias, Spain., Alperi A; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Grupo de Investigación de Patología Cardiaca, Instituto de Investigación del Principado de Asturias, Oviedo, Asturias, Spain., Hernández-Vaquero D; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Grupo de Investigación de Patología Cardiaca, Instituto de Investigación del Principado de Asturias, Oviedo, Asturias, Spain., Fernández Asensio R; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain., Cuevas Pérez J; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain., Adeba A; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain., Flórez P; Servicio de Cardiología, Hospital Valle del Nalón, Langreo, Asturias, Spain., Vigil-Escalera M; Servicio de Cardiología, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain., Álvarez Velasco R; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Grupo de Investigación de Patología Cardiaca, Instituto de Investigación del Principado de Asturias, Oviedo, Asturias, Spain., Renilla A; Servicio de Cardiología, Hospital Vital Álvarez-Buylla, Mieres, Asturias, Spain., Del Valle Fernández R; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain., Antuña P; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain., Morís de la Tassa C; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Grupo de Investigación de Patología Cardiaca, Instituto de Investigación del Principado de Asturias, Oviedo, Asturias, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain., Avanzas P; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Grupo de Investigación de Patología Cardiaca, Instituto de Investigación del Principado de Asturias, Oviedo, Asturias, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. Electronic address: avanzaspablo@uniovi.es., Pascual I; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Grupo de Investigación de Patología Cardiaca, Instituto de Investigación del Principado de Asturias, Oviedo, Asturias, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cardiologia (English ed.) [Rev Esp Cardiol (Engl Ed)] 2024 Jan; Vol. 77 (1), pp. 29-38. Date of Electronic Publication: 2023 Jul 10.
DOI: 10.1016/j.rec.2023.04.008
Abstrakt: Introduction and Objectives: Transcatheter aortic valve implantation (TAVI) using the cusp overlap technique (COT) has shown a lower pacemaker implantation rate at 30 days. The objective of this study was to compare electrocardiogram changes and clinical outcomes between COT and the traditional technique (TT) at 1 year of follow-up.
Methods: Observational, retrospective, nonrandomized study of consecutive patients undergoing TAVI between January 2015 and January 2021. Patients were matched using a propensity score and the TT was compared with COT. The primary endpoints were electrocardiogram changes and a combined endpoint including pacemaker implantation, hospitalization, or cardiovascular death at 1 year.
Results: We included 254 patients. After propensity score matching, 184 patients (92 per group) remained. There were no statistically significant differences in baseline characteristics. At 1 year, COT patients showed a significant reduction in new onset left bundle branch block (49% vs 27%, P=.002) and less P wave (13.1±21.0 msec vs 5.47±12.5 msec; P=.003) and QRS prolongation (29.77±27.0 msec vs 16.38±25.4 msec, P <.001). COT was associated with a significant reduction in the occurrence of the primary endpoint (SHR, 0.39 [IC95%, 0.21-0.76]; P=.005).
Conclusions: At 1 year of follow-up, COT reduced the incidence of new onset left bundle branch block and diminished QRS and P wave widening compared with the TT. COT was also associated with a statistically significant reduction in the occurrence of the combined primary cardiovascular endpoint.
(Copyright © 2023 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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