Abstract 14003: Prognosis Value of Aortic Valve Calcium Scoring After Transcatheter Aortic Valve Implantation performed With New Generation Prosthesis
Introduction: The degree of aortic valve calcification has been shown to be associated with paravalvular aortic regurgitation (AR) and mortality after transcatheter aortic valve implantation (TAVI).
Hypothesis: Calcium scoring of the aortic valve might no longer be a prognosis factor of adverse events after implantation of new devices designed to reduce paravalvular leaks.
Methods: In a prospective monocentric study, Agatson calcium score (CS) was evaluated on multislice computed tomography (MSCT) before TAVI in consecutive patients who had TAVI with balloon expandable SAPIEN XT (n=61) or self expandable CoreValve (n=57) (group 1, n=118), and in patients who received the new generation balloon expandable SAPIEN 3 valve (n=142). Major adverse clinical events were evaluated at 1-month follow-up (VARC-2 criteria)
Results: Main clinical characteristics did not significantly differ between the 2 groups excepted concerning logistic Euroscore (20.1% in group 1 vs 15.1% in group 2; p=0.001). Pre procedural CS value was 4092+/- 2176 in group 1 vs 4209+/- 2204 in group 2 (p=0.9). At follow-up incidence of more-than-mild AR was significantly higher in group 1 vs group 2 (n=27; 22.9% and n=10; 7.1 % respectively, p <0.01). CS was associated with occurrence of AR in group 1 (3429 +/- 1505 without AR vs 6234 +/- 2711 with AR; p<0.001), but not in group 2 (4663+/- 3057 vs 4176+/- 2149 respectively; p=0.9). Similarly, CS was associated with adverse clinical events only in group 1 (table 1). A CS value > 6000 was a major predictor of adverse events in group 1 (OR: 106; IC 95: 15.5-727.6; p<0.0001) but not in group 2 (p=0.4).
Conclusions: Severe calcifications of the aortic valve evaluated on MSCT appear to be an major prognostic parameter after TAVI performed with the second generation prosthesis but not with the new designed SAPIEN 3 valves. Impact of CS on patient selection before TAVI need probably to be reconsidered with the new generation devices .
- Aortic valve stenosis
- Percutaneous non-coronary cardiac intervention
- Cardiac CT
- Interventional cardiology
Author Disclosures: F. Leclercq: None. M. Akodad: None. A. Agullo: None. J. Macia: None. G. Marin: None. B. Lattuca: None. T. Gandet: None. L. Schmutz: None. B. Albat: None. G. Cayla: None.
- © 2016 by American Heart Association, Inc.