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Acta Cardiologica Sinica MEDLINESCIEScopus

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篇名 Temporal Change in Paravalvular Leakage after Transcatheter Aortic Valve Replacement with a Self-Expanding Valve: Impact of Aortic Valve Calcification
卷期 36:2
作者 Tsung-Yu KoHsien-Li KaoYi-Chang ChenLung-Chun LinYing-Ju LiuChih-Fan YehChing-Chang HuangYing-Hsien ChenYih-Sharng ChenMao-Shin Lin
頁次 140-147
關鍵字 Aortic valve calcificationParavalvular leakageTranscatheter aortic valve replacementMEDLINEScopusSCIE
出刊日期 202003
DOI 10.6515/ACS.202003_36(2).20190709B

中文摘要

英文摘要

Background: In patients undergoing transcatheter aortic valve replacement (TAVR), the severity of paravalvularleakage (PVL) may change during follow-up, however its mechanism is poorly understood. We aimed to exploretemporal changes in PVL and possible predictors following TAVR.Methods: A retrospective analysis was performed of all patients who had received a self-expanding valve. Multidetectorcomputed tomography was performed as pre-TAVR evaluation, including assessment of aortic valvecalcification (AVC). The patients received transthoracic echocardiography at baseline and 30 days, 6 months, and 1year after TAVR.Results: In total, 93 patients who had received a self-expanding valve during TAVRwere identified. Various degrees ofPVL were seen in 63 patients, with moderate/severe PVL in 21 (22.6%). In multivariate analysis, the predictors ofmoderate/severe PVL were: chronic pulmonary disease, high degree of AVC, and an increased annulus perimeter.After 1 year of follow-up, PVL deteriorated from mild to moderate in 2 patients, while an improvement of ≥ 1 gradewas seen in 25 patients. Of 21 patients with post-TAVR moderate/severe PVL, 9 had an improvement of ≥ 1 grade and12 did not. The degree of AVCwas significantly lower in those with PVL improvement (Agatston score 3068 ±1816 vs.6418 ± 3222; p = 0.01). AVC was a good predictor for an improvement in PVL, and the area under the receiveroperating characteristic curve was 0.82 (95% confidence interval = 0.63-1.00, p = 0.01), with a cut-off value of 5210.Conclusions: In this study, 43% (9/21) of the patients with moderate/severe PVL after self-expanding TAVR had animprovement of ≥ 1 grade within 1 year, and a low degree of AVC was predictive of this improvement.

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