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February 1, 2020EuroIntervention

Haemodynamic structural valve deterioration occurred in 10.3% of patients 12 months post-TAVI, with oral anticoagulation (RR 8.65) and valve-in-valve procedures (RR 52.76) as significant predictors.

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Why the study?

Elevated gradients are proposed to associate with haemodynamic structural valve deterioration after TAVI, but data regarding their characterisation remain scarce.

Population

691 patients undergoing transfemoral TAVI

Follow-up

12-month

Key result

Haemodynamic structural valve deterioration occurred in 10.3% of patients 12 months post-TAVI, with oral anticoagulation (RR 8.65) and valve-in-valve procedures (RR 52.76) as significant predictors.

Authors

TRTobias RheudeCPCostanza PellegriniSCSalvatore Cassese

Discussion

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Overview

May warrant closer post-TAVI surveillance in patients on OAC or with valve-in-valve; hypothesis-generating, needs confirmation before practice change.

Study Design

Type

Observational (n=691)

Structured PICO

P
Population
691 patients undergoing transfemoral transcatheter aortic valve implantation with balloon-expandable valves, followed for 12 months.
E
Exposure
Transfemoral TAVI with balloon-expandable valves
O
Outcome
Moderate or severe haemodynamic structural valve deterioration (SVD) during 12-month follow-up, defined as mean transvalvular gradient ≥20 mmHg or mean transvalvular gradient increase ≥10 mmHgsurrogate

Main Result

Relative Risk: 8.65

p-value: p=0.004 for OAC; <0.001 for valve-in-valve

Haemodynamic structural valve deterioration occurs in approximately 10% of patients within 12 months after TAVI with balloon-expandable valves, with valve-in-valve procedures and oral anticoagulation identified as significant predictors.

Cite This Study

Rheude et al. (2020) conducted an observational in Transcatheter aortic valve implantation (TAVI) (n=691). Oral anticoagulation and valve-in-valve procedure was evaluated on Moderate or severe haemodynamic structural valve deterioration (SVD) during 12-month follow-up (RR 8.65 for OAC; RR 52.76 for valve-in-valve, p=0.004 for OAC; <0.001 for valve-in-valve). Haemodynamic structural valve deterioration occurred in 10.3% of patients 12 months post-TAVI, with oral anticoagulation (RR 8.65) and valve-in-valve procedures (RR 52.76) as significant predictors.

synapsesocial.com/papers/6a7b626c02ab7a73dd034faehttps://doi.org/10.4244/eij-d-19-00710
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