In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

This content is currently on FREE ACCESS, enjoy another 18 days of free consultation

In these unprecedented times, the ESC is doing everything it can to support its community: FREE access to all ESC 365 content until 31 July: explore more than 125,000 educational resources.

From 1 August onwards, support our mission by becoming a member.

Micro-movement during transcatheter aortic valve implantation with a contemporary self-expandable prosthesis

Session Poster Session 6

Speaker Katharina Hellhammer

Event : ESC Congress 2019

  • Topic : valvular, myocardial, pericardial, pulmonary, congenital heart disease
  • Sub-topic : Valvular Heart Disease – Treatment
  • Session type : Poster Session

Authors : K Hellhammer (Düsseldorf,DE), K Piayda (Düsseldorf,DE), V Veulemans (Düsseldorf,DE), S Afzal (Düsseldorf,DE), I Hennig (Düsseldorf,DE), M Makosch (Düsseldorf,DE), A Polzin (Düsseldorf,DE), M Kelm (Düsseldorf,DE), T Zeus (Düsseldorf,DE)

K Hellhammer1 , K Piayda1 , V Veulemans1 , S Afzal1 , I Hennig1 , M Makosch1 , A Polzin1 , M Kelm1 , T Zeus1 , 1Medical Faculty, Heinrich-Heine-University, Division of Cardiology, Pulmunology and Vascular Medicine - Düsseldorf - Germany ,


Background:Precise positioning of the prosthesis is a crucial step during transcatheter aortic valve implantation. In some cases, contemporary self-expandable prostheses show micro-movement (MM) during the final phase of release.

Purpose: We aimed to establish a definition for MM, evaluated the incidence of MM using the CoreValve Evolut RTM, investigated potential risk factors for MM and the associated clinical outcomes.

Methods: MM was defined as movement of the prosthesis of at least 1.5 mm from its position directly before release compared to its final position. Patients were grouped according to the occurrence (+MM) or absence (-MM) of MM. Baseline characteristics, imaging data and outcome parameters in accordance with the updated valve academic research consortium (VARC-2) criteria were retrospectively analyzed. 

Results:We identified 258 eligible patients. MM occurred in 31.8% (n=82) of cases with a mean magnitude of 2.8 ± 2.2 mm in relation to the left coronary cusp and 3.0 ± 2.1 mm to the non-coronary cusp. Clinical and hemodynamic outcomes were similar in both groups. The mean pressure gradient was effectively reduced after TAVI (-MM vs. +MM: 7 ± 3.4 mmHg vs. 8 ± 3.9 mmHg, p=0.326) with consistency over a follow-up period of at least three months (-MM vs. +MM: 6.7 ±3.7 mmHg vs. 7.9 ±8.4 mmHg, p=0.168). At three months follow-up most of the patients presented with no aortic regurgitation (-MM vs. +MM: 64% vs. 67.9%, p=0.569). Mild aortic regurgitation was observed in 34.2% of the -MM group and in 29.5% of the +MD group (p=0.414). Moderate aortic regurgitation occurred in 1.9% of all patients with no differences between groups (-MM vs. +MM: 1.9% vs. 2.6%, p=0.662). Patients with MM presented with a more symmetric calcification pattern (-MM vs. +MM: 27.3% vs. 40.2%; p=0.037) and a larger aortic valve area (-MM vs. +MM: 0.6 cm² ± 0.3 vs. 0.7 cm² ± 0.2; p=0.014), which was found to be a potential risk factor for the occurrence of MM in a multivariate regression analysis (OR 3.5; 95%CI: 1.1-10.9; p=0.032) 

Conclusion: MM occurred in nearly one third of patients and did not affect clinical and hemodynamic outcome. A larger aortic valve area was the only independent risk factor for the occurrence of MM.

Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are