AIMS: The aim of this study was to investigate whether minimising trauma to the aortic annulus and left ventricular outflow tract reduces the occurrence of new conduction disorders and the need for permanent pacemakers. METHODS AND RESULTS: A total of 175 patients (58% female, mean age 83±6 years) underwent transfemoral TAVI with the Boston Scientific ACURATE neo at three centres in Europe. Prosthesis size selection was based on perimeter-derived annular diameter. Predilatation was performed in all with a balloon 1.9±0.9 mm smaller than the perimeter-derived annular diameter. Post-dilatation was performed in 46 (26.3%) with a balloon 1.2±0.9 mm smaller than the perimeter-derived annular diameter. Eighteen patients (10.3%) developed a new left bundle branch block, 13 (7%) a new first-degree AV block, and four (2.3%) received a new permanent pacemaker. Paravalvular regurgitation was none/trace in 66 (37.7%), mild in 101 (57.7%) and moderate in eight (4.6%). At 30 days, the rate of any stroke was 1.7% (3/175), and one patient (0.6%) had died. CONCLUSIONS: With careful selection of the balloon and the ACURATE neo prosthesis size, very low rates of new conduction disorders and permanent pacemaker implantation may be achieved without increasing the amount of paravalvular regurgitation.
AIMS: The aim of this study was to investigate whether minimising trauma to the aortic annulus and left ventricular outflow tract reduces the occurrence of new conduction disorders and the need for permanent pacemakers. METHODS AND RESULTS: A total of 175 patients (58% female, mean age 83±6 years) underwent transfemoral TAVI with the Boston Scientific ACURATE neo at three centres in Europe. Prosthesis size selection was based on perimeter-derived annular diameter. Predilatation was performed in all with a balloon 1.9±0.9 mm smaller than the perimeter-derived annular diameter. Post-dilatation was performed in 46 (26.3%) with a balloon 1.2±0.9 mm smaller than the perimeter-derived annular diameter. Eighteen patients (10.3%) developed a new left bundle branch block, 13 (7%) a new first-degree AV block, and four (2.3%) received a new permanent pacemaker. Paravalvular regurgitation was none/trace in 66 (37.7%), mild in 101 (57.7%) and moderate in eight (4.6%). At 30 days, the rate of any stroke was 1.7% (3/175), and one patient (0.6%) had died. CONCLUSIONS: With careful selection of the balloon and the ACURATE neo prosthesis size, very low rates of new conduction disorders and permanent pacemaker implantation may be achieved without increasing the amount of paravalvular regurgitation.
Authors: Alberto Alperi; Guillem Muntané-Carol; Afonso B Freitas-Ferraz; Lucia Junquera; David Del Val; Laurent Faroux; François Philippon; Josep Rodés-Cabau Journal: Ann Cardiothorac Surg Date: 2020-11
Authors: Costanza Pellegrini; Tobias Rheude; Teresa Trenkwalder; N Patrick Mayr; Jonathan Michel; Adnan Kastrati; Heribert Schunkert; Albert M Kasel; Michael Joner; Christian Hengstenberg; Oliver Husser Journal: Catheter Cardiovasc Interv Date: 2019-02-24 Impact factor: 2.692
Authors: Timo Mäkikallio; Maina P Jalava; Annastiina Husso; Marko Virtanen; Teemu Laakso; Tuomas Ahvenvaara; Tuomas Tauriainen; Pasi Maaranen; Eeva-Maija Kinnunen; Sebastian Dahlbacka; Jussi Jaakkola; Juhani Airaksinen; Vesa Anttila; Mikko Savontaus; Mika Laine; Tatu Juvonen; Antti Valtola; Peter Raivio; Markku Eskola; Matti Niemelä; Fausto Biancari Journal: Ann Med Date: 2019-05-21 Impact factor: 4.709
Authors: Costanza Pellegrini; Tobias Rheude; Jonathan Michel; Hector A Alvarez-Covarrubias; Sarah Wünsch; N Patrick Mayr; Erion Xhepa; Adnan Kastrati; Heribert Schunkert; Michael Joner; Markus Kasel Journal: J Thorac Dis Date: 2020-11 Impact factor: 2.895
Authors: Miriam Brinkert; Bart De Boeck; Simon F Stämpfli; Mathias Wolfrum; Federico Moccetti; Adrian Attinger-Toller; Matthias Bossard; Florim Cuculi; Richard Kobza; Stefan Toggweiler Journal: Open Heart Date: 2020-11