Three-year outcomes of transcatheter aortic valve implantation for bicuspid versus tricuspid aortic stenosis

Zhou, Dao; Yidilisi, Abuduwufuer; Fan, Jiaqi; Zhang, Yebei; Dai, Hanyi; Zhu, Gangjie; Guo, Yuchao; He, Yuxin; Zhu, Qionghua; Lin, Xianming; Li, Huajun; Jiang, Jianwen; Ng, Stella; Li, Cheng; Ren, Kaida; Wang, Lihan; Liu, Xianbao; Wang, Jianan

doi:10.4244/eij-d-21-00734

Cited by 24 publications

(21 citation statements)

References 31 publications

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“…Thus, since CAVD is highly correlated with age particularly among individuals over 70 years, emerging TAVR brought good news to these patients. In research, enrolling 246 consecutive AS patients who underwent TAVR, obvious hemodynamics improvement of the aortic valve and cardiac reverse remodeling were observed after a 3-year follow-up ( 29 ). Therefore, TAVR significantly improved the living qualities and reduced disabilities caused by CAVD, especially for patients with advanced ages.…”

Section: Discussionmentioning

confidence: 99%

Global burden of calcific aortic valve disease and attributable risk factors from 1990 to 2019

Wang

Bao

et al. 2022

Front. Cardiovasc. Med.

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BackgroundCalcific aortic valve disease (CAVD) was highly prevalent among developed countries and caused numerous deaths. Based on the Global Burden of Disease 2019, this study was designed to present comprehensive epidemiological information, attributable risks, and relevant factors.MethodsAll data were available online via the Global Health Data Exchange (GHDx). In this study, we analyzed the global incidence, prevalence, deaths, and disability-adjusted life years (DALYs) of CAVD across different regions from 1990 to 2019. We applied the estimated annual percentage changes (EAPCs) to evaluate the change trends and their attributable risks. In addition, we explored several relevant factors.ResultsFrom 1990 to 2019, the incidence cases, prevalence cases, CAVD-related deaths, and DALYs of CAVD gradually increased globally. However, the age-standardized death rate (ASDR) was relatively stable, and the age-standardized DALYs rate gradually declined during the past 30 years. Males and elderly individuals were more likely to suffer from CAVD. High systolic blood pressure (SBP) was the predominant attributable risk of disease burden that presented a global downward trend (death: EAPC = −0.68, 95% CI −0.77~−0.59, P < 0.001; DALYs: EAPC = −0.99, 95% CI −1.09 to −0.89, P < 0.001). Alcohol consumption (R = 0.79, P < 0.001), smoking prevalence (R = 0.75, P < 0.001), and calcium (R = 0.72, P < 0.001) showed a positive correlation with the age-standardized incidence rate (ASIR), whereas classic monsoon region (R = −0.68, P < 0.001) and mean temperature (R = −0.7, P < 0.001) showed a negative correlation with age-standardized incidence rate (ASIR). Besides, medical and healthcare resources presented a positive correlation with ASIR. Meanwhile, similar relationships were found in age-standardized prevalence rate (ASPR), ASDR, and age-standardized DALY rate (ASDALYR).ConclusionCAVD displays widely varied spatial distribution around the world, of which high SDI regions have the highest burdens. Age is a powerful factor and hypertension a predominant attributable risk factor. Moreover, controlling blood pressure, avoiding smoking, reducing alcohol consumption, and so on, could effectively reduce the burden of CAVD.

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Section: Discussionmentioning

confidence: 99%

Global burden of calcific aortic valve disease and attributable risk factors from 1990 to 2019

Wang

Bao

et al. 2022

Front. Cardiovasc. Med.

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“…Hangzhou Solution procedural strategy was used to decide prosthesis size selection in bicuspid aortic valve stenotic patients [ 10 , 11 ]. Other details of procedural strategy can be found in our previous studies [ 12 , 13 ]. The clinical adverse events were defined following the Valve Academic Research Consortium-2 consensus [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Cerebral Ischemic Lesions after Transcatheter Aortic Valve Implantation in Patients with Non-Calcific Aortic Stenosis

Liu

Zhou

Fan

et al. 2022

JCM

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Evidence for transcatheter aortic valve implantation (TAVI) is scarce among patients with non-calcific aortic stenosis, and it is not known whether aortic valve calcification is associated with new cerebral ischemic lesions (CILs) that are detected by diffusion-weighted magnetic resonance imaging. So, our study enrolled 328 patients who underwent transfemoral TAVI using a self-expanding valve between December 2016 and June 2021 from the TORCH registry (NCT02803294). A total of 34 patients were finally confirmed as non-calcific AS and the remaining 294 patients were included in the calcific AS group. Incidence of new CILs (70.6% vs. 85.7%, p = 0.022), number of lesions (2.0 vs. 3.0, p = 0.010), and lesions volume (105.0 mm3 vs. 200.0 mm3, p = 0.047) was significantly lower in the non-calcific AS group. However, the maximum and average lesion volumes were comparable between two groups. Non-calcific AS was associated with lower risk for developing new CILs by univariate logistic regression analysis [Odds ratio (OR): 0.040, 95% confident interval (CI): 0.18–0.90, p = 0.026] and multivariate analysis (OR: 0.031, 95% CI: 0.13–0.76, p = 0.010). In summary, non-calcific AS patients had a lower risk of developing new cerebral ischemic infarction after TAVI compared to calcific AS patients. However, new ischemic lesions were still found in over 70% of patients.

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“…Left ventricular ejection fraction (LVEF) estimated by the two-dimensional methods was 61.4%. Multi-detected CT (MDCT) identified that the aortic valve was bicuspid aortic valve type 1 and a raphe with a bulky calcification between the left and non-coronary sinuses ( 4 , 5 ). Further anatomical measurements on MDCT included an annular perimeter of 73.1 mm, an annular area of 414.1 mm 2 , and the left main coronary artery (LMA) ostium height of 11 mm and right coronary artery (RCA) of 14.1 mm ( Figures 1A,B,D,E ).…”

Section: Case Presentationmentioning

confidence: 99%

“…The procedure was performed in our hybrid operating room for TAVR as previously described ( 4 ). At the beginning of the TAVR procedure, bilateral coronary arteries were patent under intraoperative fluoroscopy ( Figure 2A ).…”

Section: Case Presentationmentioning

confidence: 99%

Emergently Alteration of Procedural Strategy During Transcatheter Aortic Valve Replacement to Prevent Coronary Occlusion: A Case Report

Dai

Zhou²,

Fan³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundCoronary occlusion is an uncommon but fatal complication of transcatheter aortic valve replacement (TAVR) with a poor prognosis.Case PresentationA patient with symptomatic severe bicuspid aortic valve stenosis was admitted to a high-volume center specializing in transfemoral TAVR with self-expanding valves. No anatomical risk factors of coronary occlusion were identified on pre-procedural computed tomography analysis. The patient was scheduled for a transfemoral TAVR with a self-expanding valve. Balloon pre-dilatation prior to prosthesis implantation was routinely used for assessing the supra-annular structure and assessing the risk of coronary occlusion. Immediately after the tubular balloon inflation, fluoroscopy revealed that the right coronary artery was not visible, and the flow in the left coronary artery was reduced. The patient would be at high-risk of coronary occlusion if a long stent self-expanding valve was implanted. Therefore, our heart team decided to suspend the ongoing procedure. A transapical TAVR with a 23 mm J-valve was performed 3 days later. The prosthesis was deployed at a proper position without blocking the coronary ostia and the final fluoroscopy showed normal flow in bilateral coronary arteries with the same filling as preoperatively.DiscussionOur successful case highlights the importance of a comprehensive assessment of coronary risk and a thorough understanding of the TAVR procedure for the heart team. A short-stent prosthesis is feasible for patients at high risk of coronary occlusion. Most importantly TAVR should be called off even if the catheter has been introduced when an extremely high risk of coronary obstruction is identified during the procedure and no solution can be found.

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Three-year outcomes of transcatheter aortic valve implantation for bicuspid versus tricuspid aortic stenosis

Cited by 24 publications

References 31 publications

Global burden of calcific aortic valve disease and attributable risk factors from 1990 to 2019

Global burden of calcific aortic valve disease and attributable risk factors from 1990 to 2019

Cerebral Ischemic Lesions after Transcatheter Aortic Valve Implantation in Patients with Non-Calcific Aortic Stenosis

Emergently Alteration of Procedural Strategy During Transcatheter Aortic Valve Replacement to Prevent Coronary Occlusion: A Case Report

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