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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Association between three-year mortality after transcatheter aortic valve implantation and paravalvular regurgitation graded by videodensitometry in comparison with visual grading
Clinical Research in Cardiology, Year 2023
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Description
Background: Estimation of regurgitant fraction by videodensitometry (VD-AR) of aortic root angiograms is a new tool for objective grading of paravalvular regurgitation (PVR) after transcatheter aortic valve implantation (TAVI). Stratification with boundaries at 6% and 17% has been proposed to reflect “none/trace”, “mild” and “moderate or higher” PVR. Objective: We sought to investigate the association of strata of VD-AR with 3-year mortality and to compare VD-AR with visual grading of angiograms. Methods: We interrogated our database for patients undergoing transfemoral TAVI from 2008 to 2018. Vital status of the patients was obtained from population registers. To test differences in survival and estimate adjusted hazard ratios (HRs) we fitted Cox models. Results: Our retrospective study included 699 patients with evaluable angiograms at completion of the TAVI procedure. Cumulative 3-year mortality was 35.0% in 261 (37.3%) patients with VD-AR < 6%, 33.9% in 325 (46.5%) patients with VD-AR between 6 and 17% (HR [95% confidence interval] 1.06 [0.80–1.42]; P = 0.684) and 47.2% in 113 (16.2%) patients with VD-AR > 17% (HR 1.57 [1.11–2.22]; P = 0.011). Visually, PVR was graded as “none/trace” in 470 (67.2%) patients, as “mild” in 219 (31.3%) and as “moderate” in 10 (1.4%). Both mild PVR and moderate PVR on visual grading were significantly associated with mortality (HRs 1.31 [1.12–1.54]; P = 0.001 and 1.92 [1.13–3.24]; P = 0.015; respectively). Conclusions: VD-AR > 17%, but not VD-AR 6–17%, was independently associated with mortality. Compared with subjective visual evaluation, VD-AR resulted in a smaller proportion of patients with PVR classified as prognostically relevant. Graphical Abstract: [Figure not available: see fulltext.] © 2023, The Author(s).
Authors & Co-Authors
Elzomor, Hesham
Ireland, Galway
Saolta University Health Care Group
Ireland, Galway
University of Galway
Abdelshafy, Mahmoud
Ireland, Galway
Saolta University Health Care Group
Ireland, Galway
University of Galway
Elkoumy, Ahmed
Ireland, Galway
Saolta University Health Care Group
Ireland, Galway
University of Galway
Soliman, O. I.I.
Ireland, Galway
Saolta University Health Care Group
Ireland, Galway
University of Galway
Westermann, Dirk
Germany, Freiburg Im Breisgau
Universitätsklinikum Freiburg
Germany, Freiburg Im Breisgau
Universität Freiburg
Neumann, Franz Josef
Germany, Freiburg Im Breisgau
Universitätsklinikum Freiburg
Germany, Freiburg Im Breisgau
Universität Freiburg
Serruys, Patrick Washington
Ireland, Galway
Saolta University Health Care Group
Ireland, Galway
University of Galway
Statistics
Authors: 7
Affiliations: 4
Identifiers
Doi:
10.1007/s00392-023-02280-7
ISSN:
18610684
Research Areas
Environmental
Study Design
Cross Sectional Study
Cohort Study