Aortic valve anatomy and outcomes after transcatheter aortic valve implantation in bicuspid aortic valves

Autor: Antonios Mastrokostopoulos, Nicolas Dumonteil, Didier Tchetche, Kamel Rehal, Louis Marie Desroche, Chiara De Biase, Raphael Philippart, Stephanie Blanco
Rok vydání: 2017
Předmět:
Aortic valve
Male
medicine.medical_treatment
Heart Valve Diseases
030204 cardiovascular system & hematology
Cohort Studies
0302 clinical medicine
Bicuspid aortic valve
Bicuspid Aortic Valve Disease
Ventricular outflow tract
030212 general & internal medicine
Fisher's exact test
Aged
80 and over
education.field_of_study
Multidisciplinary
Mortality rate
Anatomy
medicine.anatomical_structure
Treatment Outcome
Aortic Valve
symbols
Medicine and Dentistry
cardiovascular system
lcsh:R858-859.7
Female
Cardiology and Cardiovascular Medicine
Transcatheter aortic
Population
lcsh:Computer applications to medicine. Medical informatics
Transcatheter Aortic Valve Replacement
symbols.namesake
03 medical and health sciences
medicine.artery
Multidetector Computed Tomography
medicine
Humans
Mortality
lcsh:Science (General)
education
Aged
Aorta
business.industry
Percutaneous coronary intervention
medicine.disease
Stenosis
Propensity score matching
Transthoracic echocardiogram
business
lcsh:Q1-390
Follow-Up Studies
Zdroj: Data in Brief
Data in Brief, Vol 17, Iss, Pp 667-670 (2018)
ISSN: 1874-1754
Popis: Purpose Aortic stenosis (AS) in bicuspid aortic valve (BAV) remains a challenge for transcatheter aortic valve implantation (TAVI). BAV is a condition encountered in young adults as well as elderly patients. Frequently we face in clinical practice elderly patients with BAV and severe AS, but there is little evidence concerning TAVI in this population. The aim of our study was to compare anatomic features and outcomes of bicuspid and tricuspid patients with AS undergoing TAVI. Methods 83 consecutive BAV patients undergoing TAVI were matched, in a 1:2 ratio, to 166 tricuspid patients. Multi-detector computed tomography (MDCT) and transthoracic echocardiogram (TTE) were assessed at baseline. Primary endpoint was all-cause mortality and early safety at 30 days according to Valve Academic Research Consortium criteria 2 (VARC-2). Secondary endpoint included device success. Results BAV patients presented more aortic root calcifications, smaller diameter of left ventricular outflow tract (LVOT) and dilated aorta. We did not observe any statistically significant difference concerning all-cause mortality and early safety at 30 days. However higher intra-procedural TAV-in-TAV bailout procedure was observed in the BAV cohort, with consequent reduction of device success rate. Conclusions Patients with BAV present more complex anatomy at baseline as compared to tricuspid AS patients. These anatomical features lead to more frequent TAV-in-TAV bailout procedure and lower device success rate, but are not associated with higher mortality rate at 30 days. Our findings support the feasibility of TAVI in BAV, but larger studies with longer follow-up and a focus on sizing are required.
Databáze: OpenAIRE
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