Key result
Annular calcium volume is linked to ~138% higher odds of TAVI valve underexpansion.
Why the study?
Procedural factors associated with transcatheter heart valve underexpansion after TAVI with the self-expanding ACURATE platform remain incompletely understood.
Does annular calcium volume predict valve underexpansion in patients undergoing TAVI with the ACURATE THV?
Observational
No
Does annular calcium volume predict valve underexpansion in patients undergoing TAVI with the ACURATE THV?
Annular calcium volume is a significant predictor of valve underexpansion during TAVI with the ACURATE neo valve, whereas post-dilatation may reduce this deformation.
Annular calcium volume was associated with ACURATE valve underexpansion in this cohort; leaves open whether quantification should guide device selection or post-dilatation.
BACKGROUND: Transcatheter heart valve (THV) deformation after transcatheter aortic valve implantation (TAVI) using the self-expanding ACURATE platform has been associated with impaired clinical outcomes in a randomised trial. Procedural factors associated with THV deformation remain incompletely understood. AIMS: We aimed to investigate procedural factors associated with valve underexpansion, mainly derived from preprocedural computed tomography angiography (CTA) imaging. METHODS: A single-centre, retrospective, observational study was carried out, including patients who underwent TAVI with an ACURATE THV between January 2014 and December 2022, with available CTA and procedural fluoroscopy. Aortic calcium volume was quantified using 3mensio software. Fluoroscopy was used to determine valve frame underexpansion. RESULTS: ) confirmed the significant association with valve frame underexpansion (OR 2.38, 95% CI: 1.37-4.19; p=0.002). CONCLUSIONS: Annular calcium volume was shown to be associated with underexpanded ACURATE THVs, while post-dilatation may reduce valve deformation.
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Alvarez‐Covarrubias et al. (2025) conducted an observational in Patients undergoing TAVI with an ACURATE THV. Annular calcium volume was evaluated on Valve frame underexpansion (OR 2.38, 95% CI 1.37-4.19, p=0.002). Annular calcium volume was significantly associated with valve frame underexpansion (OR 2.38; 95% CI 1.37-4.19; p=0.002), while post-dilatation may reduce valve deformation.
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