Does frame geometry play a role in aortic regurgitation after Medtronic CoreValve implantation?

EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Ramón Rodríguez-OlivaresPeter de Jaegere

Abstract

Aortic regurgitation (AR) after Medtronic CoreValve System (MCS) implantation may be explained by patient-, operator- and procedure-related factors. We sought to explore if frame geometry, as a result of a specific device-host interaction, contributes to AR. Using rotational angiography with dedicated motion compensation, we assessed valve frame geometry in 84 patients who underwent TAVI with the MCS. Aortic regurgitation was assessed by angiography (n=84, Sellers) and echocardiography at discharge (n=72, VARC-2). Twenty-two patients (26%) had AR grade ≥2 using contrast angiography, and 17 (24%) by echocardiography. Balloon predilatation and sizing and depth of implantation did not differ between the two groups. Despite more frequent balloon post-dilatation in patients with AR (40.9 vs. 9.7%, p=0.001), the frame was more elliptical at its nadir relative to the patient's annulus (6±13 vs. -1±11%, p=0.046) and occurred in a larger proportion of patients (61.9 vs. 26.8%, p=0.004). Although the Agatston score and the eccentricity of the MCS frame relative to the annulus were independent determinants of AR (odds ratio: 1.635 [1.151-2.324], p=0.006, and 4.204 [1.237-14.290], p=0.021), there was a weak association between the Agatston...Continue Reading

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Citations

May 4, 2016·The International Journal of Cardiovascular Imaging·Ramón Rodríguez-OlivaresPeter P T de Jaegere
Apr 15, 2016·European Heart Journal·Mohammad AbdelghaniPatrick W Serruys
Mar 16, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Edward KoifmanRon Waksman
Sep 9, 2017·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Sandrine EgronUlrich Steinseifer
Nov 27, 2016·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·N El FaquirP P de Jaegere
Jun 29, 2017·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Petra HoppmannChristian Kupatt
Dec 16, 2019·JACC. Cardiovascular Interventions·Kerstin PiaydaTobias Zeus
May 22, 2018·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Ramón Rodríguez-OlivaresNicolas M Van Mieghem

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