Christian Butter1, Maki Okamoto1, Gerhard Schymik2, Claudius Jacobshagen3, Jürgen Rothe4, Hendrik Treede5, Sebastian Kerber6, Derk Frank7,8, Peter Bramlage9, Lenka Sykorova10, Martin Thoenes10, Tanja K Rudolph11. 1. Department of Cardiology, Immanuel Clinic Bernau, Heart Center Brandenburg and Brandenburg Medical School (MHB), Bernau bei Berlin, Germany. 2. Medical Clinic IV, Department of Cardiology, Municipal Hospital, Karlsruhe, Germany. 3. Heart Centre, University of Göttingen, Göttingen, Germany. 4. Division of Cardiology and Angiology II, University Heart Centre Freiburg-Bad Krozingen, Bad Krozingen, Germany. 5. Universitätsklinik und Poliklinik für Herzchirurgie, Universitätsklinikum Halle, Halle, Germany. 6. Department of Cardiology, Cardiovascular Center, Bad Neustadt, Germany. 7. ZHK (German Centre for Cardiovascular Research), Hamburg, Germany. 8. Department of Internal Medicine III (Cardiology and Angiology), University Hospital Schleswig-Holstein, Kiel, Germany. 9. Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany. 10. Edwards Lifesciences, Nyon, Switzerland. 11. Heart Centre, University of Cologne, Cologne, Germany.
Abstract
AIMS: We aimed to assess whether the level of aortic root calcification is associated with BAV performance/omission during transcatheter aortic valve implantation (TAVI), and to explore related outcomes. METHODS AND RESULTS: EASE-IT TF was a prospective, observational, multicenter registry of patients undergoing TF-TAVI with the Edwards SAPIEN 3, with or without BAV predilation. Valvular calcification was quantified from pre-procedural multi-slice computed tomography images and compared between BAV and no BAV patients. Data for 178 patients (55 BAV; 123 no BAV) were analyzed. There were no significant differences between groups in terms of regional/leaflet sector calcification volumes, maximum asymmetry between the different leaflet sectors, or total calcification scores. Overall, a greater-than-average leaflet calcification volume was independently predictive of ≥mild PVL (OR: 5.116; 95% CI: 1.042-38.35) and the need for post-dilation (OR: 3.592; 95% CI: 1.173-12.14). The latter effect was abated in patients with BAV (OR: 1.837; 95% CI: 0.223-18.00) and intensified in those without BAV (OR: 5.575; 95% CI: 1.114-38.74). No other BAV-dependent effects of calcification on outcomes were observed. CONCLUSIONS: In the majority of transfemoral valve implantations, calcification does not appear to be the main driving factor in the decision to perform/omit BAV. Predilation may be valuable for reducing post-dilation requirements in patients only with a greater degree of leaflet calcification.
AIMS: We aimed to assess whether the level of aortic root calcification is associated with BAV performance/omission during transcatheter aortic valve implantation (TAVI), and to explore related outcomes. METHODS AND RESULTS: EASE-IT TF was a prospective, observational, multicenter registry of patients undergoing TF-TAVI with the Edwards SAPIEN 3, with or without BAV predilation. Valvular calcification was quantified from pre-procedural multi-slice computed tomography images and compared between BAV and no BAV patients. Data for 178 patients (55 BAV; 123 no BAV) were analyzed. There were no significant differences between groups in terms of regional/leaflet sector calcification volumes, maximum asymmetry between the different leaflet sectors, or total calcification scores. Overall, a greater-than-average leaflet calcification volume was independently predictive of ≥mild PVL (OR: 5.116; 95% CI: 1.042-38.35) and the need for post-dilation (OR: 3.592; 95% CI: 1.173-12.14). The latter effect was abated in patients with BAV (OR: 1.837; 95% CI: 0.223-18.00) and intensified in those without BAV (OR: 5.575; 95% CI: 1.114-38.74). No other BAV-dependent effects of calcification on outcomes were observed. CONCLUSIONS: In the majority of transfemoral valve implantations, calcification does not appear to be the main driving factor in the decision to perform/omit BAV. Predilation may be valuable for reducing post-dilation requirements in patients only with a greater degree of leaflet calcification.
Authors: Florence Leclercq; Pierre Alain Meunier; Thomas Gandet; Jean-Christophe Macia; Delphine Delseny; Philippe Gaudard; Marc Mourad; Laurent Schmutz; Pierre Robert; François Roubille; Guillaume Cayla; Mariama Akodad Journal: J Clin Med Date: 2022-05-16 Impact factor: 4.964
Authors: Jannik Ole Ashauer; Nikolaos Bonaros; Markus Kofler; Gerhard Schymik; Christian Butter; Mauro Romano; Vinayak Bapat; Justus Strauch; Holger Schröfel; Andreas Busjahn; Cornelia Deutsch; Peter Bramlage; Jana Kurucova; Martin Thoenes; Stephan Baldus; Tanja K Rudolph Journal: BMC Cardiovasc Disord Date: 2019-07-19 Impact factor: 2.298
Authors: Gerhard Schymik; Tanja Rudolph; Claudius Jacobshagen; Jürgen Rothe; Hendrik Treede; Sebastian Kerber; Derk Frank; Lenka Sykorova; Maki Okamoto; Martin Thoenes; Cornelia Deutsch; Peter Bramlage; Christian Butter Journal: Open Heart Date: 2019-10-03