Abstract 19135: Impact of New Cardiac Conduction Disturbances After TAVI on Myocardial Contractility and Mortality
Introduction: Our study aimed to evaluate the impact of procedure-related cardiac conduction disturbances (CCD) on myocardial performance (standard and speckle-tracking-based LV function parameters) after transfemoral aortic valve implantation (TAVI TF).
Hypothesis: New cardiac conduction disturbances after TAVI impair LV function and morphology as well as survival.
Methods: Between 2010 and 2013, 168 patients (pts.) underwent TAVI TF using the Core Valve at our institution. 95 of them with complete follow-up (mean follow up 264± 241 days) were evaluated with respect to the presence of new CCD and their effect on myocardial performance.
Results: Aortic valve orifice and mean gradient significantly improved (from 0.7 ± 0.2 to 1.8 ± 0.4 cm2, p<0.001 and from 42.4 ± 17.7 to 8.3 ± 4.0 mmHg, p<0.001, respectively). After TAVI, 37.9% of pts. presented with new CCDs. Pts. without additional CCDs showed an improvement of left ventricular systolic and diastolic function (LVEF from 43.7 ± 16.5% to 48 ± 16.2%, p= 0.004; E/A-ratio from 1.4 ± 1.0 to 1.0 ± 0.9, p= 0.006), whereas pts. with procedure-related CCDs had a mild LVEF deterioration (from 51.8 ± 13.9% to 47.3 ± 8.5%, p=0.16). Comparison of the changes between groups without and with CCDs revealed significant differences (Table 1). However, on Kaplan Meier analysis survival was not significantly different between both groups (p=0.73).
Conclusions: Procedure-related conductions abnormalities after TAVI impair LV function, however in our pt. cohort with no impact on overall survival.
Author Disclosures: Z. Dimitriadis: None. S. Scholtz: Honoraria; Modest; Medtronic. Other; Modest; Direct Flow Medical. W. Scholtz: Honoraria; Modest; Direct Flow Medical, Medtronic. Other; Modest; Direct Flow Medical. M. Wiemer: None. C. Piper: None. S. Ensminger: Honoraria; Modest; Edwards, Symetis. Consultant/Advisory Board; Modest; Edwards, Jena Valve. Other; Modest; Edwards, Symetis. H. Fox: None. D. Horstkotte: None. L. Faber: None.
- © 2015 by American Heart Association, Inc.