Abstract 18162: Does Transcatheter Aortic Valve Replacement Have Acute Impact on Right Ventricular Function ?
Background and Aim: Transcatheter aortic valve replacement (TAVR) is now an established alternative to surgical aortic valve replacement in selected high risk aortic stenosis patients. Whether early changes in right ventricular function (RVF) are seen immediately post-TAVR is not known. We aimed to evaluate the impact of TAVR on acute changes in RVF using detailed quantitative analysis.
Methods and Results: 103 patients who underwent TAVR at a single-center were retrospectively studied. Each patient’s pre-TAVR echocardiogram (TTE) and immediate post-TAVR TTE performed prior to discharge date from TAVR hospital admission were analyzed along with baseline demographic and clinical variables. RVF was assessed with M-mode, Tissue Doppler and global performance index (Tei index; TEI 1 = pulsed doppler, TEI 2=tissue doppler) on pre and post-TAVR TTE. Pre and post comparisons were done using paired t-tests and data are presented as mean and 95% confidence interval (CI). The mean patient population age was 81.9, with 49% males. Table 1 outlines the pre and post-TAVR echocardiographic changes in quantitative RV function assessed in the early post-TAVR follow-up period. An acute improvement in RVF with Tei index indicates that TAVR may have beneficial effects both on systolic and diastolic function accompanied by a decline in RV-RA pressure difference suggesting lower post TAVR RV systolic pressure.
Conclusion: Our study is the first study demonstrating an improvement in RVF acutely post-TAVR utilizing a comprehensive RV TTE analysis. A more global RVF index combining systolic and diastolic RV performance (Tei index) may be a better marker than regional systolic function parameters . Thus, Tei index could be integrated into part of the pre-post RVF assessment evaluation in patients undergoing TAVR.
Table1: Right Ventricular Function Pre and Post-TAVR
TAPSE: tricuspid annular plane systolic excursion, FAC: fractional area change, TR: tricuspid regurgitation
Author Disclosures: Y. Nasr: None. D. Wang: None. G. Dirani: None. D. Yanoschik: None. S. Tanmay: None. M. Mahan: None. M. Guerrero: Consultant/Advisory Board; Modest; Consultant and Proctor Edwards Lifesciences. A. Greenbaum: None. W. O’Neill: Consultant/Advisory Board; Modest; Consultant to Edwards and MDT. K. Ananthasubramaniam: Research Grant; Significant; GE Healthcare, Astellas Pharma US Inc.
- © 2014 by American Heart Association, Inc.