Abstract 17679: Impact of Transcatheter Aortic Valve Replacement (TAVR) on Left Ventricular Diastolic Function; Comparison with Surgical Aortic Valve Replacement (sAVR)
Introduction: Little was known about the effect of transcatheter aortic valve replacement (TAVR) on serial change of left ventricular (LV) diastolic function.
Hypothesis: The aim of this study was to assess impact of TAVR on LV diastolic function compare to surgical aortic valve replacement (sAVR) in patients with symptomatic high risk severe aortic stenosis.
Methods: Thirty-eight patients who underwent TAVR (mean age: 80±6 years, M:F= 18:20) and twenty-seven age- and sex-matched patients who had sAVR (mean age:78±3 years, M:F= 12:15) were included for this study. We compared changes of LV diastolic function by serial transthoracic echocardiography before procedure, immediate after procedures, and 3 month later.
Results: Patients in the TAVR group had more co-morbidities, and higher the Society of Thoracic Surgeons risk score (8.7±4.2 vs. 5.8±4.3, p=0.028) and the logistic Euroscore (25.8±16.9 vs. 13.8±13.0, p=0.011) compared to those in the sAVR group. In both groups, E velocity was significantly increased after procedure (TAVR: 84.0±31.6 vs. 92.1±26.3; sAVR: 68.4±24.6 vs. 83.6±17.5 cm/sec, p<0.001) and E’ velocity was increased (TAVR: 3.6±1.2 vs. 4.6±1.3; sAVR:3.7±1.4 vs. 4.4±1.8 cm/sec, p=0.008). Deceleration time was significantly decreased (TAVR: 201±64 vs. 216±65; sAVR: 205±54 vs. 239±54 msec, p=0.043) and S’ velocity was increased (TAVI: 4.4±1.3 vs. 5.1±1.3; sAVR:4.8±1.1 vs. 5.7±2.3 cm/sec, p=0.008). In TAVR group, improvement diastolic function grade was observed at immediate after procedure compare to sAVR group (TAVR: 16 (42%) vs sAVR: 3 (11%), P=0.018). However, diastolic function improvement was similar at 3 months in both group(p=0.88).
Conclusions: Our results show that improvement of LV diastolic function is more rapid in TAVR group, despite of higher baseline risks, these results might corroborate to explain the remarkable clinical improvements in patients with advanced diastolic dysfunction immediate after TAVR compared to sAVR.
Author Disclosures: S. Ha: None. I. Cho: None. C. Shim: None. J. Lee: None. P. Chipeta: None. H. Chang: None. G. Hong: None. J. Ha: None. N. Chung: None.
- © 2014 by American Heart Association, Inc.