Post transcatheter aortic valve replacement ejection fraction response is predictor of survival among patients with whole range of systolic dysfunction

Kiliçaslan, Barış; Ünal, Barış; Coşkun, Mehmet; Zeren, Gönül; Ekin, Tuba; Özcan, Sevgi; Erdogan, Sıddık; Özdemir, Emre; Deniz, Orsan; Ertaş, Faruk; Karabay, Can Yücel; Kaya, Derya; Okuyan, Ertuğrul; Barçın, Cem; Nazlı, Cem; Kurt, Ibrahim Halil; Yilmaz, Mehmet Birhan

doi:10.1080/00015385.2020.1843853

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…23 Similar findings were observed after TAVR with immediate improvement of EF, especially in patients with low EF. 24 Moreover, TAVR improved EF in low flow and low gradient patients with impaired ventricular function. 4…”

Section: Discussionmentioning

confidence: 96%

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Surgical vs Transcatheter Aortic Valve Replacement in Patients With a Low Ejection Fraction

et al. 2022

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Currently, there is no preference for surgical (SAVR) vs transcatheter (TAVR) aortic valve replacement in patients with low ejection fraction (EF). The present study retrospectively compared the outcomes of SAVR vs TAVR in patients with EF ≤40% (70 SAVR and 117 TAVR patients). Study outcomes were survival and the composite endpoint of stroke, aortic valve reintervention, and heart failure readmission. The patients who had TAVR were older (median: 75 (25-75th percentiles: 69-81) vs 51 (39-66) years old; P < .001) with higher EuroSCORE II (4.95 (2.99-9.85) vs 2 (1.5-3.25); P < .001). Postoperative renal impairment was more common with SAVR (8 (12.5%) vs 4 (3.42%); P = .03), and they had longer hospital stay [9 (7-15) vs 4 (2-8) days; P < .001). There was no difference between groups in stroke, reintervention, and readmission (Sub-distributional Hazard ratio: .95 (.37-2.45); P = .92). Survival at 1 and 5 years was 95% and 91% with SAVR and 89% and 63% with TAVR. Adjusted survival was comparable between groups. EF improved significantly (β: .28 (.23-.33); P < 0.001) with no difference between groups ( P = .85). In conclusion, TAVR could be as safe as SAVR in patients with low EF.

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Section: Discussionmentioning

confidence: 96%

“…Similar findings were observed after TAVR with immediate improvement of EF, especially in patients with low EF. 24 Moreover, TAVR improved EF in low flow and low gradient patients with impaired ventricular function. 4 A budget impact analysis was conducted in Saudi Arabia and included our institution comparing TAVR vs SAVR.…”

Section: Discussionmentioning

confidence: 96%

Surgical vs Transcatheter Aortic Valve Replacement in Patients With a Low Ejection Fraction

et al. 2022

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“…A positive relationship between ejection fraction and BP match ratios suggests that individuals with higher ejection fractions might experience better agreement between the two methods, potentially due to higher cardiac output and more stable hemodynamics after TAVR with higher ejection fraction [18]. The data also indicates that individuals with larger valve sizes may have higher agreement between the two methods, possibly related to the impact of valve size on blood flow dynamics and non-invasive measurement method reliability [19]. Lastly, the observed gender differences in BP match ratios may be attributed to variations in vascular structure, hormonal influences, or other factors requiring further investigation [20,21].…”

Section: Discussionmentioning

confidence: 99%

Comparison of direct intra-arterial pressure and ClearSight finger cuff arterial pressure measurements in elderly patients undergoing transcatheter aortic valve replacement

Yahagi,

Sasaki

2023

Blood Pressure Monitoring

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Objective: This study aimed to assess the agreement between direct intra-arterial pressure and ClearSight finger cuff arterial pressure measurements in elderly patients undergoing transcatheter aortic valve replacement (TAVR). Methods: A prospective observational study was conducted at Hitachi General Hospital, Japan, involving 30 patients aged 65 years and older who underwent TAVR under general anesthesia. Intra-arterial pressure and finger cuff arterial pressure measurements were recorded for 30 min after valve deployment. Bland–Altman analysis, four-quadrant plot analysis, and error grid analysis were used to assess the concordance between the two methods. Multiple regression analysis was performed to explore potential confounding factors affecting the agreement. Results: The bias and precision of ClearSight measurements were −4.88 ± 15.46 (mmHg) for SBP, 4.73 ± 8.95 (mmHg) for mean, and 9.53 ± 9.01 (mmHg) for DBP. The Bland–Altman analysis demonstrated acceptable agreement between intra-arterial pressure and finger cuff arterial pressure measurements. The four-quadrant plot analysis showed good trend-tracking ability, and the error grid analysis revealed that most of the observed values fell into the no-risk category. The mean BP match ratio and SBP match ratio were influenced by several factors such as age, BSA, ejection fraction, valve size, and gender. Conclusion: The ClearSight finger cuff arterial pressure measurement showed good agreement with direct intra-arterial pressure in elderly patients undergoing TAVR. However, factors such as age, BSA, ejection fraction, valve size, and gender may influence the agreement between the two methods.

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First successful transcatheter valve-in-valve implantation into a failed mechanical prosthetic aortic valve facilitated by fracturing of the leaflets: a case report

Butter¹,

Kühnel

Hölschermann³

2021

European Heart Journal - Case Reports

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Background Degenerated and failed bioprosthetic cardiac valves can safely be treated with transcatheter valve-in-valve implantation in patients at high risk for reoperation. So far, non-functional mechanical valves must be treated with a surgical redo. Breaking the carbon leaflets before implanting a transcatheter valve into the remaining ring has never been described before. Case summary Here, we present the case of a 65-year-old male patient with severe heart failure, poor left ventricular function based on a fully immobile disc of his mechanical bileaflet aortic valve implanted 7 years ago. After the heart team declined to reoperate the patient due to his extremely high risk, we considered a transcatheter valve-in-valve implantation as the ultimate treatment approach. After successful interventional cracking of the leaflets in vitro, this approach, together with implanting a balloon-expandable transcatheter aortic valve replacement (TAVR) into the remaining ring, was performed under cerebral protection. The intervention resulted in a fully functional TAVR, improvement of heart function, and early discharge from the hospital. Discussion This case demonstrates the possibility to implant a transcatheter valve successfully into a non-functional mechanical bileaflet aortic prosthesis after fracturing the carbon discs while the brain is protected by a filter system. Critical steps of the procedure were identified. This new therapeutic approach might be offered to a limited patient cohort who is not eligible for a surgical redo.

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Post transcatheter aortic valve replacement ejection fraction response is predictor of survival among patients with whole range of systolic dysfunction

Cited by 3 publications

References 21 publications

Surgical vs Transcatheter Aortic Valve Replacement in Patients With a Low Ejection Fraction

Surgical vs Transcatheter Aortic Valve Replacement in Patients With a Low Ejection Fraction

Comparison of direct intra-arterial pressure and ClearSight finger cuff arterial pressure measurements in elderly patients undergoing transcatheter aortic valve replacement

First successful transcatheter valve-in-valve implantation into a failed mechanical prosthetic aortic valve facilitated by fracturing of the leaflets: a case report

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