Why the study?
Pre-procedure ECG-gated CT aortography is important in planning TAVI, and the study aimed to correlate aortic valve calcium score with post-TAVI complications.
Does the aortic valve calcium score predict post-TAVI complications (PVL and MACE) in patients with severe symptomatic aortic stenosis?
Does the aortic valve calcium score predict post-TAVI complications (PVL and MACE) in patients with severe symptomatic aortic stenosis?
Aortic valve calcium score assessed by pre-procedural CT strongly correlates with and can predict post-TAVI complications such as paravalvular leak and MACE.
May support calcium scoring for TAVI risk stratification; hypothesis-generating, needs prospective validation.
Background Severe symptomatic aortic stenosis is a common disorder in the elderly and is associated with high morbidity and mortality rate. Traditionally, surgical aortic valve replacement has been considered the most effective treatment for advanced disease. Transcatheter aortic valve implantation (TAVI) has been established as a valuable alternative treatment option for inoperable and high-risk patients with symptomatic severe aortic stenosis. Pre-procedure ECG-gated CT aortography study is important in planning the procedure. The aim of the study was to correlate the aortic valve calcium score with the post-TAVI complications. Results Thirty patients who were candidates for TAVI procedure were enrolled for ECG-gated CT aortic valve calcium score and CT aortography. The calcium score was calculated. The patients were followed up both clinically and by echocardiography every 3 months for 1 year. Those who developed complications were enrolled for another CT study. Fourteen out of 30 patients (46.7%) presented with post-TAVI complications [9 cases (30%) presented with paravalvular leak (PVL) and 5 cases (16.7%) presented with major adverse cardiac events (MACE), while 16 cases (53.3%) had no complications]. There was a strong correlation between the calcium score and post-procedure complications. Conclusions The degree of aortic valve calcification can be considered as a predictor of post-TAVI complications: PVL and MACE.
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Salem et al. (2022) studied this question.
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