TY - JOUR
T1 - Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world
AU - Arai, Takahide
AU - Lefèvre, Thierry
AU - Hovasse, Thomas
AU - Garot, Philippe
AU - Benamer, Hakim
AU - Unterseeh, Thierry
AU - Roy, Andrew K.
AU - Romano, Mauro
AU - Hayashida, Kentaro
AU - Watanabe, Yusuke
AU - Bouvier, Erik
AU - Morice, Marie Claude
AU - Chevalier, Bernard
PY - 2017
Y1 - 2017
N2 - Objectives: Coronary obstruction (CO) is a rare but serious complication of transcatheter aortic valve implantation (TAVI). There are very limited data regarding CO following TAVI. The aim of this study was to evaluate the incidence and outcomes of CO after TAVI and identify the predictors including the valve type. Methods: Between October 2006 and March 2015, 1,203 TAVI cases were performed in our institution. Of them, 814 cases whose coronary height was measured using computed tomography for screening were analyzed in this study. Results: The Edwards SAPIEN/SAPIEN XT (S/XT) was used in 427 (52.4%) cases, the CoreValve in 265 (32.6%), and the S3 in 122 (15.0%). CO occurred in 8 (1.0%) cases, 1.6% with S/XT, 0.4% with CoreValve, and 0% with S3. All instances of CO occurred at the left coronary artery. The 30-day mortality was significantly higher in cases of CO (37.5% vs. 5.8%, P=0.010). The frequency of CO tended to be lower in recipients of the CoreValve (0.4%) and S3 (0%) compared with the S/XT (1.6%) (P=0.188 for CoreValve vs. S/XT, P=0.022 for S3 vs. S/XT). Conclusions: CO has poor outcomes and identification of patients at risk of CO to take preventive measures is crucial. The preliminary data showing that the occurrence of CO is low in patients receiving the S3 despite increased prosthesis height need further confirmation.
AB - Objectives: Coronary obstruction (CO) is a rare but serious complication of transcatheter aortic valve implantation (TAVI). There are very limited data regarding CO following TAVI. The aim of this study was to evaluate the incidence and outcomes of CO after TAVI and identify the predictors including the valve type. Methods: Between October 2006 and March 2015, 1,203 TAVI cases were performed in our institution. Of them, 814 cases whose coronary height was measured using computed tomography for screening were analyzed in this study. Results: The Edwards SAPIEN/SAPIEN XT (S/XT) was used in 427 (52.4%) cases, the CoreValve in 265 (32.6%), and the S3 in 122 (15.0%). CO occurred in 8 (1.0%) cases, 1.6% with S/XT, 0.4% with CoreValve, and 0% with S3. All instances of CO occurred at the left coronary artery. The 30-day mortality was significantly higher in cases of CO (37.5% vs. 5.8%, P=0.010). The frequency of CO tended to be lower in recipients of the CoreValve (0.4%) and S3 (0%) compared with the S/XT (1.6%) (P=0.188 for CoreValve vs. S/XT, P=0.022 for S3 vs. S/XT). Conclusions: CO has poor outcomes and identification of patients at risk of CO to take preventive measures is crucial. The preliminary data showing that the occurrence of CO is low in patients receiving the S3 despite increased prosthesis height need further confirmation.
KW - Coronary obstruction
KW - Severe symptomatic aortic stenosis
KW - Transcatheter aortic valve implantation
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U2 - 10.1002/ccd.26982
DO - 10.1002/ccd.26982
M3 - Article
C2 - 28295996
AN - SCOPUS:85015152371
SN - 1522-1946
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
ER -