Impact of Left Ventricular Outflow Tract Calcification on Pacemaker Implantation After Transcatheter Aortic Valve Implantation With Second-Generation Devices

Marco B. Ancona, Francesco Moroni, Matteo Pagnesi, Paolo Del Sole, Ozan Demir, Saud Khawaja, Barbara Bellini, Luca Ferri, Alessandro Beneduce, Emanuele Visco, Cristina Capogrosso, Eustachio Agricola, Antonio Esposito, Anna Palmisano, Alaide Chieffo, Matteo Montorfano

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To evaluate the impact of left ventricular outflow tract calcification (LVOT-CA) localization and extension on permanent pacemaker implantation (PPI) rates after transcatheter aortic valve implantation (TAVI) with second-generation devices. METHODS: This single-center retrospective study included all consecutive patients who underwent transfemoral TAVI with second-generation devices at San Raffaele Hospital in Milan, Italy from January 2014 to June 2017. The localization and extension of LVOT-CA were evaluated using computed tomography imaging; LVOT regions were categorized according to the overlying coronary cusps. RESULTS: The study population consisted of 377 patients, of which LVOT-CA was present in 133 patients (35.3%). Patients with LVOT-CA had significantly a higher rate of post-TAVI PPI (32.0% vs 19.2% in patients with no LVOT-CA; P<.01). Multivariable analysis demonstrated LVOT-CA in the non-coronary cusp, as well as preprocedural right bundle-branch block, age, body mass index, and mechanically expanded prosthesis implantation, to be strong independent predictors of PPI. CONCLUSIONS: LVOT-CA in the non-coronary cusp is a strong independent predictor of PPI after TAVI with second-generation devices. Further studies are needed to confirm these data in a larger, multicenter population.

Original languageEnglish
Pages (from-to)180-185
Number of pages6
JournalThe Journal of invasive cardiology
Volume32
Issue number5
Publication statusPublished - May 1 2020

Keywords

  • calcification
  • left ventricular outflow tract
  • TAVI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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