Aortic annulus calcification correlated with CoreValve stent frame eccentricity (ρ=0.241, P=0.003), which was significantly associated with paravalvular leakage severity (ρ=0.525, P<0.0001).
Observational (n=223)
Is native aortic root calcium burden associated with stent frame eccentricity and paravalvular leakage after TAVI in patients with severe aortic stenosis?
Aortic annulus calcification is associated with an eccentric shape of the CoreValve prosthesis, which significantly correlates with increased severity and specific localization of paravalvular leakage.
Estimación del efecto: ρ = 0.525
valor p: p=< 0.0001
AIMS: Paravalvular aortic leakage (PVL) after transcatheter aortic valve implantation (TAVI) is a complication with potentially severe consequences. The relation between native aortic root calcium burden, stent frame eccentricity and PVL was not studied before. METHODS AND RESULTS: Two-hundred-and-twenty-three consecutive patients with severe aortic stenosis who underwent TAVI with a Medtronic CoreValve System© and who had available pre-discharge transthoracic echocardiography were studied. Echocardiographic stent inflow frame eccentricity was defined as major-minor diameter in a short-axis view >2 mm. PVL was scored according to the updated Valve Academic Research Consortium (VARC-2) recommendations. In a subgroup of 162 (73%) patients, the calcium Agatston score was available. Stent frame eccentricity was seen in 77 (35%) of patients. The correlation between the Agatston score and stent frame eccentricity was significant (ρ = 0.241, P = 0.003). Paravalvular leakage was absent in 91 cases (41%), mild in 67 (30%), moderate in 51 (23%), and severe in 14 (6%) cases. The correlation between stent frame eccentricity and PVL severity was significant (ρ = 0.525, P < 0.0001). There was a relation between particular eccentric stent frame shapes and the site of PVL. CONCLUSION: Calcification of the aortic annulus is associated with a subsequent eccentric shape of the CoreValve prosthesis. This eccentric shape results in more PVL, with the localization of PVL related to the shape of stent frame eccentricity.
Martino et al. (Mon,) conducted a observational in Severe aortic stenosis (n=223). TAVI with Medtronic CoreValve System was evaluated on Correlation between stent frame eccentricity and paravalvular leakage severity (ρ = 0.525, p=< 0.0001). Aortic annulus calcification correlated with CoreValve stent frame eccentricity (ρ=0.241, P=0.003), which was significantly associated with paravalvular leakage severity (ρ=0.525, P<0.0001).