Micro-dislodgement during transcatheter aortic valve implantation with a contemporary self-expandable prosthesis


Autoři: Katharina Hellhammer aff001;  Kerstin Piayda aff001;  Shazia Afzal aff001;  Verena Veulemans aff001;  Inga Hennig aff001;  Matthias Makosch aff001;  Amin Polzin aff001;  Malte Kelm aff001;  Tobias Zeus aff001
Působiště autorů: University Hospital Düsseldorf, Medical Faculty, Department of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany aff001;  CARID (Cardiovascular Research Institute Düsseldorf), Düsseldorf, Germany aff002
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224815

Souhrn

Objectives

To evaluate the incidence, risk factors and the clinical outcome of micro-dislodgement (MD) with a contemporary self-expandable prosthesis during transcatheter aortic valve implantation.

Methods

MD was defined as movement of the prosthesis of at least 1.5 mm upwards or downwards from its position directly before release compared to its final position. Patients were grouped according to the occurrence (+MD) or absence (-MD) of MD. Baseline characteristics, imaging data and outcome parameters were retrospectively analyzed.

Results

We identified 258 eligible patients. MD occurred in 31.8% (n = 82) of cases with a mean magnitude of 2.8 mm ± 2.2 in relation to the left coronary cusp and 3.0 mm ± 2.1 to the non-coronary cusp. Clinical and hemodynamic outcomes were similar in both groups with consistency over a follow-up period of three months. A larger aortic valve area (AVA) (-MD vs. +MD: 0.6 cm2 ± 0.3 vs. 0.7cm2 ± 0.2; p = 0.014), was the only independent risk factor for the occurrence of MD in a multivariate regression analysis (OR 5.3; 95% CI: 1.1–24.9; p = 0.036).

Conclusions

MD occurred in nearly one third of patients and did not affect clinical and hemodynamic outcome. A larger AVA seems to be a potential risk factor for MD.

Klíčová slova:

Aorta – Aortic valve – Calcification – Hemodynamics – Medical implants – Medical risk factors – Prosthetics – Regression analysis


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 11