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Aortic valve calcium score and peri-prothesis leaks after transcatheter aortic valve implantation: is there a hint?
Session:
Posters (Sessão 3 - Écran 8) - Doença Valvular 3 - Válvula Aórtica
Speaker:
Ana Amador
Congress:
CPC 2022
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.2 Valvular Heart Disease – Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Ana Filipa Amador; Catarina Martins da Costa; , João Calvão; Ricardo Alves Pinto; Miguel Martins Carvalho; Tânia Proença; Catarina Amaral Marques; André Cabrita; Pedro Grilo Diogo; Carlos Xavier Resende; Cátia Oliveira; Ana Isabel Pinho; Luís Daniel Santos; Carla Margarida Sousa; Filipe Macedo
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:"interstateregular",serif"><span style="color:black">Introduction: Aortic valvular calcium score (AVCS) measured by tomography scans is useful in the evaluation of aortic stenosis (AS) severity in patients for whom echocardiography is not conclusive. For high-risk patients with symptomatic severe AS, transcatheter aortic valve implantation (TAVI) is an established procedure of treatment. The burden of aortic valve calcification has been associated with some TAVI related complications. Peri-prothesis leaks (PPL) are an important complication that may compromise TAVI net results. </span></span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:"interstateregular",serif"><span style="color:black">Purpose: To access if there is an association between aortic valve calcium score and moderate to severe (mod-sev) peri-prothesis leaks immediately and 6 months after TAVI. </span></span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:"interstateregular",serif"><span style="color:black">Methods: We performed a single-center, retrospective cohort study including patients who underwent TAVI with a preoperative standardized TS with AVCS available. Clinical and echocardiographic data were collected previously to TAVI (pre-TAVI) and at 6 months follow up (6M-FUP). </span></span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:"interstateregular",serif"><span style="color:black">Results: A total of 187 patients were included, with 54% female and a mean age of 79.4± 9.0 years old. Most patients had tricuspid aortic valve (95.7%). Regarding prosthesis type, 73.3% had new generation prosthesis and the main valve used was the CoreValve Evolut Pro (33.7%). 38.5% patients underwent balloon valve pre-dilation before implantation. The mean AVCS was 2851±1524 AU (Agaston Units). Comparing AVCS with the presence or absence of moderate to severe peri-prothesis leaks, no statistically significant difference was found immediately (no vs mod-sev leak, AS: 2758±2308 vs 3621±1376, p= 0,13) and 6 months after the procedure (no vs mod-sev leak, AS: 2892±2366 vs 3621±1424, p=0.15). Considering earlier (Portico, CoreValve Evolut R) vs newer valves (CoreValve Evolut Pro; Edward Sapiens 3; Accurate Neo), there was no statistically significant difference relating AVCS and PPL; however, in patients who had newer valves there was a trend to higher AVCS and moderate to severe leaks, both on the immediate (no vs mod-sev leak, AS: 2777±2507 vs 3601±1385, p=0.07) and at 6 months (no vs mod-sev leak, AS: 2782±2506 vs 3984±1138, p=0.06). No statistically significant difference was found when comparing pre-ballooning dilatation. </span></span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:"interstateregular",serif"><span style="color:black">Conclusion: Aortic calcium measured by Agatston score did not show an association with new moderate to severe peri-valvular leaks after TAVI. Nevertheless, it seems to be a trend for higher AS and moderate to severe peri-prothesis leaks when newer valves are implanted.</span></span></span></span></span></p>
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