Long-term outcomes of new-onset conduction abnormalities following transcatheter aortic valve implantation

Tomii, Daijiro; Okuno, Taishi; Heg, Dik; Pilgrim, Thomas; Windecker, Stephan

doi:10.1016/j.acvd.2022.04.005

Cited by 7 publications

(4 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For THV bioprostheses, early studies used measured EOA to predict the incidence of PPM, however following the report of expected normal hemodynamics following TAVR (20), predicted PPM could be determined. As expected, the predicted PPM rates were significantly lower than measured PPM (3,22). A study from the PARTNER 2, SAPIEN 3 registry compared predicted and measured EOA and showed a lower incidence of PPM when using the predicted EOAi method compared to the 30-day measured EOAi, with a lower incidence of PPM in TAVR compared to SAVR (Figure 2) (23).…”

Section: Introductionmentioning

confidence: 58%

Prosthesis-patient mismatch in transcatheter and surgical aortic valve replacement

Hahn,

Pibarot

2024

Ann Cardiothorac Surg

View full text Add to dashboard Cite

Prosthesis-patient mismatch (PPM) occurs when the effective orifice area (EOA) of a normally functioning prosthetic valve is too small in relation to the patient's body size. The effect of PPM on outcomes and valve durability have gained credibility, making this an important possibly preventable risk factor. Transcatheter aortic valve replacement (TAVR) generally has a lower incidence of PPM than surgical aortic valve replacement (SAVR). Current surgical literature and randomized trials show an association between severe PPM and mortality in patients with SAVR but there is less evidence for an association with TAVR.Differences in the incidence of PPM may be related to the methods and cutoffs for measuring mismatch. This review will discuss the current state of field and propose standardization of measurement methods which may more accurately risk stratify patients.

show abstract

Section: Introductionmentioning

confidence: 58%

Prosthesis-patient mismatch in transcatheter and surgical aortic valve replacement

Hahn,

Pibarot

2024

Ann Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…Similarly, in a propensity score analysis of a large SAVR study with a mean age of 70 years, overall mortality was significantly higher in patients with new PPM implantation versus those without (HR 1.14, 95% CI 1.01-1.29; p = 0.03) [41]. In another study, after multivariable adjustment, the impact on all-cause mortality was statistically significant for new LBBB, whereas the association did not reach the conventional level of statistical significance for new PPM implantation [42]. Also, recent data from the STS/TVT Registry encompassing 9.785 TAVI recipients revealed a higher risk in one-year all-cause mortality among patients who had a PPM after TAVI (adjusted hazard ratio 1.31; 95% CI: 1.09-1.58; p = 0.003) [43].…”

Section: Impact Of New Lbbb New Ca and Ppm Implantationmentioning

confidence: 94%

Transcatheter Aortic Valve Implantation and Conduction Disturbances: Focus on Clinical Implications

Halapas,

Koliastasis,

Doundoulakis

et al. 2023

JCDD

View full text Add to dashboard Cite

Transcatheter aortic valve implantation (TAVI) is an established alternative to surgery in patients with symptomatic severe aortic stenosis and has expanded its indications to even low-surgical-risk patients. Conduction abnormalities (CA) and permanent pacemaker (PPM) implantations remain a relatively common finding post TAVI due to the close proximity of the conduction system to the aortic root. New onset left bundle branch block (LBBB) and high-grade atrioventricular block are the most commonly reported CA post TAVI. The overall rate of PPM implantation post TAVI varies and is related to pre- and intra-procedural factors. Therefore, when screening patients for TAVI, Heart Teams should take under consideration the various anatomical, pathophysiological and procedural conditions that predispose to CA and PPM requirement after the procedure. This is particularly important as TAVI is being offered to younger patients with longer life-expectancy. Herein, we highlight the incidence, predictors, impact and management of CA in patients undergoing TAVI.

show abstract

“…The available results on the clinical impacts of PPI after TAVR show a paradoxical trend. Some studies have shown that post-TAVR PPI may not be associated with increased adverse events, including all-cause mortality and cardiovascular death (78). A multicenter cohort study concerning the long-term outcomes of PPI after TAVR reported similar overall or 77) also concluded that patients who underwent PPI after TAVR seemed to have a clearly higher risk of 1-year mortality and heart failure hospitalization or repeat hospitalization than patients who did not undergo PPI.…”

Section: Impact Of the High Degree Of Atrioventricular Block And Perm...mentioning

confidence: 97%

“…The available results on the clinical impacts of PPI after TAVR show a paradoxical trend. Some studies have shown that post-TAVR PPI may not be associated with increased adverse events, including all-cause mortality and cardiovascular death ( 78 ). A multicenter cohort study concerning the long-term outcomes of PPI after TAVR reported similar overall or cardiovascular mortality rates at 4 years between patients with and without PPI after TAVR but a significantly greater rehospitalization risk for heart failure (22.4% vs. 16.1%; adjusted HR: 1.42; 95% CI: 1.06–1.89; p = 0.019) and a trend toward lower LVEF ( p = 0.051 for between-group LVEF change) in PPI patients, especially those with preexisting LV dysfunction ( p = 0.005 for between-group LVEF change) ( 76 ).…”

Section: The Types and Effects Of Conduction Abnormalities After Tavrmentioning

confidence: 99%

Predictors, clinical impact, and management strategies for conduction abnormalities after transcatheter aortic valve replacement: an updated review

Yu,

Fu,

Xia

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Transcatheter aortic valve replacement (TAVR) has increasingly become a safe, feasible, and widely accepted alternative surgical treatment for patients with severe symptomatic aortic stenosis. However, the incidence of conduction abnormalities associated with TAVR, including left bundle branch block (LBBB) and high-degree atrioventricular block (HAVB), remains high and is often correlated with risk factors such as the severity of valvular calcification, preexisting conditions in patients, and procedural factors. The existing research results on the impact of post-TAVR conduction abnormalities and permanent pacemaker (PPM) requirements on prognosis, including all-cause mortality and rehospitalization, remain contradictory, with varied management strategies for post-TAVR conduction system diseases across different institutions. This review integrates the latest research in the field, offering a comprehensive discussion of the mechanisms, risk factors, consequences, and management of post-TAVR conduction abnormalities. This study provides insights into optimizing patient prognosis and explores the potential of novel strategies, such as conduction system pacing, to minimize the risk of adverse clinical outcomes.

show abstract

Long-term outcomes of new-onset conduction abnormalities following transcatheter aortic valve implantation

Cited by 7 publications

References 35 publications

Prosthesis-patient mismatch in transcatheter and surgical aortic valve replacement

Prosthesis-patient mismatch in transcatheter and surgical aortic valve replacement

Transcatheter Aortic Valve Implantation and Conduction Disturbances: Focus on Clinical Implications

Predictors, clinical impact, and management strategies for conduction abnormalities after transcatheter aortic valve replacement: an updated review

Contact Info

Product

Resources

About