Mid-term impact of underfilling and overfilling of the SAPIEN 3 balloon-expandable transcatheter aortic valve implantation on mortality and valve function View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-06-18

AUTHORS

Kenichi Ishizu, Shinichi Shirai, Hiroaki Tashiro, Kazuki Kitano, Hiroyuki Tabata, Toru Morofuji, Miho Nakamura, Naoto Murakami, Takashi Morinaga, Masaomi Hayashi, Akihiro Isotani, Yoshio Arai, Nobuhisa Ohno, Shinichi Kakumoto, Kenji Ando

ABSTRACT

At present, underfilling or overfilling the volume of the balloon-expandable transcatheter heart valve (THV) is generally utilized in transcatheter aortic valve implantation (TAVI). However, no research has assessed the clinical impact of filling volume variations of the current-generation SAPIEN 3 THV. We analyzed the clinical data of 331 patients who underwent TAVI with SAPIEN 3 at our institution. Post-procedural echocardiographic and multidetector computed tomography (MDCT) scan data and 3-year prognoses according to each filling volume were assessed. The procedural outcomes and 3-year mortality rates were comparable among the underfilling, nominal filling, and overfilling groups. For all THV sizes, the THV area evaluated on post-procedural MDCT scan increased stepwise along with an elevated filling volume, thereby covering a wide range of native annulus area. Compared with patients in the nominal filling and overfilling groups, those with 23-mm THVs in the underfilling group had a smaller effective orifice area (EOA) (1.38 [IQR: 1.18–1.56] vs. 1.57 [IQR: 1.41–1.84] vs. 1.58 [IQR: 1.45–1.71] cm2, P = 0.02) and a higher mean transvalvular gradient (13.6 [IQR: 11.0–15.7] vs. 12.1 [IQR: 9.0–14.9] vs. 12.0 [IQR: 8.1–14.8] cm2, P = 0.04). In conclusion, by adjusting the filling volume of SAPIEN 3 using THV with limited sizes, continuously distributed native annulus areas were covered. The underfilling implantation technique had a minimal negative effect on the valve function of 23-mm THVs only. In the entire cohort, the filling volume variations did not affect the mid-term prognosis negatively. More... »

PAGES

1-16

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-022-02109-9

DOI

http://dx.doi.org/10.1007/s00380-022-02109-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1148785419

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35716209


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