Abstract 15979: Association of Annular Size with Aortic Valve Regurgitation after TAVI with Medtronic CoreValve and Edwards Sapien XT
Purpose: Transcatheter Aortic Valve Implantation (TAVI) is becoming the mainstay for treatment of high-risk non-operable patients with aortic valve stenosis. Aortic valve regurgitation (AVR) is a common finding following TAVI. We studied the possible correlation of post TAVI AVR with the valve type, size and annular size.
Methods: Between April 2009 and May 2012, TAVI was performed in 157 high-risk patients with severe aortic stenosis (100 patients received the Medtronic CoreValve-MCV and 57 patients received the Edwards Sapien XT-EXT; age: 79.93±6.84 years; logistic Euroscore 23.36±12.05%; 58% female; NYHA III 79.6%; aortic valve mean gradient 50.46±14.3mmHg). AVR was evaluated based on the American Society of Echocardiography classification (none, mild, moderate, severe).
Results: Annular size was greater in patients with MCV compared to patients with EXT (22.39±2.17mm vs 20.65±1.82mm, p<0.001). Mean annular size in 23mm EXT was 20.04±1.44mm vs 22.22±1.79mm in 26mm EXT (p<0.01). Mean annular size was 20.66±0.97mm in 26mm MCV vs 24.23±1.31 in 29mm MCV (p<0.001). Patients with MCV had greater rates of moderate and severe AVR compared to EXT (34.8% vs 14%, p<0.001; Figure shows the percentage of patients with all AVR degrees in all valves). Patients with severe AVR had a mean annulus size of 25.33±0.57mm compared to those with moderate AVR who had 22.25±1.96mm, p<0.01.
Conclusions: Post TAVI AVR is more frequent in patients with greater aortic valve annular size. In addition, patients receiving the Medtronic CoreValve have greater degree of AVR after implantation.
- © 2012 by American Heart Association, Inc.