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Echocardiographic changes in TAVI: Comparison of direct versus non-direct TAVI with a self-expanding bioprosthesis.

Session Poster session 4

Speaker Konstantinos Toutouzas

Event : ESC Congress 2015

  • Topic : imaging
  • Sub-topic : Echocardiography
  • Session type : Poster Session

Authors : K Stathogiannis (Athens,GR), K Toutouzas (Athens,GR), G Latsios (Athens,GR), A Synetos (Athens,GR), E Sanidas (Athens,GR), M Drakopoulou (Athens,GR), S Yuecel (Bonn,DE), U Gerckens (Bonn,DE), E Grube (Bonn,DE), D Tousoulis (Athens,GR)

Authors:
K. Stathogiannis1 , K. Toutouzas1 , G. Latsios1 , A. Synetos1 , E. Sanidas2 , M. Drakopoulou1 , S. Yuecel3 , U. Gerckens3 , E. Grube4 , D. Tousoulis1 , 1Hippokration Hospital, University of Athens, 1st Department of Cardiology - Athens - Greece , 2Laiko University General Hospital - Athens - Greece , 3Gemeinschaftskrankenhaus - Bonn - Germany , 4University Hospital, Dept of Medicine II - Bonn - Germany ,

Citation:
European Heart Journal ( 2015 ) 36 ( Abstract Supplement ), 595-596

Background: Direct transcatheter aortic valve implantation (TAVI) without balloon aortic valvuloplasty (BAV) is commonly used in TAVI with the self-expanding bioprosthesis.

Purpose: The aim of this study was to compare the echocardiographic parameters of patients undergoing TAVI with or without BAV with a self-expanding bioprosthesis.

Methods: A total of 210 patients (120 patients for non-direct TAVI and 90 patients for direct TAVI) with severe aortic valve stenosis were analysed. All patients underwent transthoracic echocardiogram prior to the procedure and before discharge.

Results: The direct group had less moderate/severe paravalvular leakage (PVL) post TAVI compared to the non-direct group (8% vs 27%, p<0.01). Both groups had similar 1-year mortality rates (15% in non-direct versus 11% in direct, p=0.5). The Table depicts the echocardiographic differences between the 2 groups before and after the procedure.

Conclusions: Patients undergoing direct TAVI have less moderate/severe paravalvular leakage and similar mortality rates compared to patients with non-direct TAVI.

Non-direct (n=120)Direct (n=90)P value
Pre
  Mean gradient, mmHg43±1549±14<0.01
  Aortic valve area, cm20.6±0.20.6±0.10.5
  Velocity (max), m/sec4±0.84.2±1.10.7
  Paravalvular leakage, n (%)0.4
    None25 (21%)18 (20%)
    Mild57 (48%)50 (56%)
    Moderate / Severe38 (31%)22 (24%)
Post
  Mean gradient, mmHg9±410±60.14
  Aortic valve area, cm21.4±0.31.6±0.50.054
  Velocity (max), m/sec1.96±0.62±0.70.5
  Paravalvular leakage, n (%)<0.01
    None21 (18%)15 (17%)
    Mild66 (55%)68 (75%)
    Moderate / Severe33 (27%)7 (8%)

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