Abstract 3178: Permanent Improvement of Ejection Fraction after Transcutaneous Aortic Valve Implantation in Patients with Aortic Stenosis and Deteriorated Left Ventricle.
Background: Normalization of ejection fraction (EF) after surgery accounts for less than 50% of patients with aortic stenosis (AS) and deteriorated EF. In this study, we assessed left ventricular function recovery after transcutaneous aortic valve replacement (TAVR) in AS patients.
Methods and results: 35 consecutive symptomatic AS patients (mean age: 77±9y) from our center were included. All were declined by 2 surgical teams due to major comorbidities and subsequently referred for TAVR. Patients were imaged by echocardiography for Simpson’s volumes and EF, transmitral velocity profile and aortic valve area measurements. At baseline, patients were divided into 2 groups (G1: EF<35%, n=12 and G2: EF> 35%, n=23) and compared 1 month after TAVR. Before implantation (see table⇓), G1 had more dilated left ventricle, lower EF but comparable mitral E/A ratio despite similar aortic valve area as compared to G2. At 1-month F/U (see table⇓), patients in G1 had enhanced EF, showed reduction in left ventricular systolic volume and mitral E/A ratio, while G2 experienced no change in EF and mitral E/A ratio but significant increase both in systolic and diastolic volumes. All patients in G1 improved their EF (see figure⇓).
Conclusion: After TAVR for AS, systolic and diastolic function was remarkably enhanced in all patients with low EF but remained unchanged in those with normal contractility.