A valve calcification index ≥517.4 predicted a lower 30-day survival rate (80.0% vs. 97.2%, P<0.01), and VCI was an independent predictor of 30-day mortality (OR 1.003; 95% CI 1.001-1.005).
Cohort (n=162)
Does a higher aortic root calcification volume (measured by VCI) predict worse clinical outcomes in patients undergoing TAVI with a balloon-expandable valve?
A higher valve calcification index measured by preprocedural MDCT is an independent predictor of 30-day mortality and procedural complications after balloon-expandable TAVI.
Absolute Event Rate: 80% vs 97.2%
p-value: p=<0.01
BACKGROUND: Few data are available about whether aortic root calcification may impact the outcomes after transcatheter aortic valve implantation (TAVI). OBJECTIVES: This study sought to evaluate the impact of aortic root calcification volume on clinical outcome after TAVI with balloon expandable Edwards Sapien XT valve (Edwards Lifesciences, Irvine, California). METHODS: A total of 162 TAVI patients (aged 84.0 Interquartile Range (IQR) 81.0-84.0 years, Logistic EuroSCORE 14.5 IQR 9.8-25.1) with preprocedural MDCT were studied. Aortic root calcification volume was measured by MDCT image and using the dedicated software for aortic valve assessment (the automated 3mensio™ Valves 5.1, sp1, 3mensio Pie Medical Imaging BV, Maastricht, the Netherlands). A valve calcification index (VCI) was defined as calcification volume (mm(3))/body surface area (mm(2)). RESULTS: VCI was significantly higher among patients with 30-day mortality. A VCI threshold of 517.4 (area under the curve 0.69, 95% CI 0.50-0.87, P = 0.03) predicted a higher incidence of annulus rupture (9.1 vs. 0.9%, P = 0.02) and cardiac tamponade (12.7 vs. 1.9%, P < 0.01), lower device success (83.6% vs. 95.3%, P < 0.01) and 30-day survival rate (80.0% vs. 97.2%, P < 0.01). Multivariate logistic regression analysis showed only ejection fraction and VCI were identified as independent predictors of 30-day mortality (Odds ratio 0.948 95% confidence interval 0.909-0.988, P = 0.012, Odds ratio 1.003 95% confidence interval 1.001-1.005, P = 0.013, respectively). CONCLUSIONS: Significantly worse acute clinical outcomes after Edwards valve implantation were observed in patients with large amount of aortic annulus calcifications quantitatively measured by dedicated MDCT software. Application of VCI may prove helpful in prediction of clinical outcomes after TAVI.
Watanabe et al. (2015) conducted a cohort in Transcatheter aortic valve implantation (TAVI) (n=162). High valve calcification index (VCI ≥ 517.4) vs. Low valve calcification index (VCI < 517.4) was evaluated on 30-day survival rate (p=<0.01). A valve calcification index ≥517.4 predicted a lower 30-day survival rate (80.0% vs. 97.2%, P<0.01), and VCI was an independent predictor of 30-day mortality (OR 1.003; 95% CI 1.001-1.005).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: