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Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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The Flutter-by Effect in Transcatheter Aortic Valve Implantation Bioprosthesis
Session:
Sessão de Posters 05 - Ecocardiografia
Speaker:
Gonçalo Ferraz Costa
Congress:
CPC 2024
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Cartazes
FP Number:
---
Authors:
Gonçalo Ferraz Costa
Abstract
<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Background</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Aortic stenosis (AS) is one of the most common valve diseases associated with high mortality if untreated. Transcatheter aortic valve implantation (TAVI) is a well-established therapeutic option and is offered increasingly to patients of lower risk. Echocardiography is the first-line exam to evaluate AS patients before and after the procedure. Flutter-by effect is an ultrasound finding reported in surgical biological aortic prosthesis, which has been speculated to compromise valve function. However, the flutter-by effect prevalence on TAVI and its clinical significance is still unknown.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Aim</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">The aim of this study was to assess the prevalence of the flutter-by effect in patients undergoing TAVI and to evaluate its clinical significance through its effects on pressure gradients across the prosthetic aortic valve, as well as its impact on complications and mortality.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Material and methods</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">This study is a retrospective, single-center cohort study. Subjects underwent TAVI between January and September 2022. All data regarding patient characteristics, intraprocedural data, echocardiographic findings, and complications were retrospectively collected from the clinic's database. Transthoracic echocardiography was performed within eight days post-TAVI and during follow-up. We investigated the presence of this effect according to valve brand, dimensions, and baseline left ejection fraction. All statistical analyses were conducted using SPSS 29.0.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Results</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">The prevalence of the flutter-by effect was 19.5% at baseline and 25.1% at follow-up, with no significant difference between the two measurement points. No significant differences were found between patients with and without the flutter-by effect for any of the examined echocardiographic measurements. There was a significant difference in the prevalence of the flutter-by effect at baseline according to the EF grouping at baseline (p=0.017), but not at follow-up (p=0.227). The flutter-by effect was more prevalent in the Accurate Neo2 valve. At one-year follow-up, there were no significant differences in complications, hospitalizations, and mortality between participants with and without the flutter-by effect.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Conclusion</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Our study suggests that the flutter-by effect is a normal finding post-TAVI. </span></span></span></p>
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