TY - JOUR
T1 - Does pre-existing aortic regurgitation protect from death in patients who develop paravalvular leak after TAVI?
AU - Colli, Andrea
AU - Besola, L
AU - Salizzoni, S
AU - Gregori, Dario
AU - Tarantini, Giuseppe
AU - Agrifoglio, M
AU - Chieffo, A
AU - Regesta, T
AU - Gabbieri, D
AU - Saia, F
AU - Tamburino, C
AU - Ribichini, F
AU - Valsecchi, Orazio
AU - Loi, B
AU - Iadanza, Alessandro
AU - Stolcova, M
AU - Minati, A
AU - Martinelli, G
AU - Bedogni, F
AU - Petronio, Anna Sonia
AU - Dallago, M
AU - Cappai, A
AU - D'Onofrio, A
AU - Gerosa, Gino
AU - Rinaldi, Mauro
PY - 2017
Y1 - 2017
N2 - Objective The aim of this study was to investigate interactions among pre-procedural aortic regurgitation (AR), post-procedural paravalvular leak (PVL) and long-term clinical outcomes. Methods and results We analyzed data prospectively collected in the Italian Transcatheter balloon-Expandable Registry (ITER) on aortic stenosis (AS) patients. The degree of pre-procedural AR and post-procedural PVL was stratified as: absent/trivial, mild, and moderate/severe. VARC definitions were applied to outcomes. Of 1708 patients, preoperatively, AR was absent/trivial in 40% of the patients, mild in 42%, and moderate in 18%. Postoperatively, PVL was moderate–severe in 5%, mild in 32% of patients, and absent/trivial in 63%. Clinical follow-up, median 821 days (IQR 585.75), was performed in 99.7% of patients. PVL, but not preoperative AR, was a major predictor of adverse outcome (HR 1.33, CI 95% 0.9–2.05, p = 0.012 for mild PVL, HR 1.36, CI 95% 0.9–2.05, p 75 ml/m2) showed better survival than those without dilatation (HR 8.63, p = 0.001). Conclusions In patients with severe AS treated with balloon-expandable TAVI, the presence of PVL, but not pre-procedural AR, was a major predictor of adverse outcome. Preoperative LV dilatation seemed to offer some clinical advantages. © 2017 Elsevier B.V.
AB - Objective The aim of this study was to investigate interactions among pre-procedural aortic regurgitation (AR), post-procedural paravalvular leak (PVL) and long-term clinical outcomes. Methods and results We analyzed data prospectively collected in the Italian Transcatheter balloon-Expandable Registry (ITER) on aortic stenosis (AS) patients. The degree of pre-procedural AR and post-procedural PVL was stratified as: absent/trivial, mild, and moderate/severe. VARC definitions were applied to outcomes. Of 1708 patients, preoperatively, AR was absent/trivial in 40% of the patients, mild in 42%, and moderate in 18%. Postoperatively, PVL was moderate–severe in 5%, mild in 32% of patients, and absent/trivial in 63%. Clinical follow-up, median 821 days (IQR 585.75), was performed in 99.7% of patients. PVL, but not preoperative AR, was a major predictor of adverse outcome (HR 1.33, CI 95% 0.9–2.05, p = 0.012 for mild PVL, HR 1.36, CI 95% 0.9–2.05, p 75 ml/m2) showed better survival than those without dilatation (HR 8.63, p = 0.001). Conclusions In patients with severe AS treated with balloon-expandable TAVI, the presence of PVL, but not pre-procedural AR, was a major predictor of adverse outcome. Preoperative LV dilatation seemed to offer some clinical advantages. © 2017 Elsevier B.V.
U2 - 10.1016/j.ijcard.2017.02.005
DO - 10.1016/j.ijcard.2017.02.005
M3 - Article
VL - 233
SP - 52
EP - 60
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 4
ER -