Abstrakt
Aortic regurgitation after TAVI is associated with worse prognosis. It is described frequently in patients with bicuspid or severely calcified valves as well as in patients with an excentricity of the aortic annulus based on cardiac CT measurements.
The purpose of our study was to evaluate the incidence of post-procedural AR GREATER-THAN OR EQUAL TO 2-4/4 after TAVI, to determine the relationship between anatomical parameters of the valve and the incidence of AR as well as clinical and echocardiography follow-up 1 and 12 months after TAVI. We included 96 patients.
The mean age was 80.1 +- 7.1 years. Each patient underwent TTE, TEE and CT before the procedure.
All patients underwent follow-up 1, 6 and 12 months after TAVI, which included a clinical examination and an echocardiography examination. For further analysis, we divided our study population into two groups, patients with none or mild AR (0<2/4) and patients with moderate or severe AR (GREATER-THAN OR EQUAL TO2-4/4).
Results: 19 (14.6%) patients had AR GREATER-THAN OR EQUAL TO 2-4/4 after the procedure. In these patients, a significantly larger aortic annulus 26 +- 2.5 mm vs. 25 +- 2.2 mm (p=0.06) and a significantly larger ascending aorta 35.4 +- 3.6 vs. 32.6 +- 3.6 mm (p= 0.01) were found.
The index of excentricity was not significantly larger in this group of patients 0.12 +- 0.09 vs. 0.12 +- 0.08 (p = 0.91). The EF increased in both groups.
In patients with AR 0<2/4 it increased from 51% to 55.6% (p<0.01). There was no statistical difference between clinical follow-up based on functional class NYHA (p = 0.068).
Conclusions: Dimensions of aortic annulus and ascending aorta predicted post-procedural AR, however patients in our study population did not have a significantly lower EF or worse clinical outcome.