Depth of valve implantation, conduction disturbances and pacemaker implantation with CoreValve and CoreValve Accutrak system for Transcatheter Aortic Valve Implantation, a multi-center study.
Lenders, Guy D.; Collas, Valerie; Hernandez, Jose Mariaet al.
Depth of valve implantation; Left Bundle Branch Block (LBBB); Pacemaker; Transcatheter Aortic Valve Implantation (TAVI)
Abstract :
[en] BACKGROUND: Transcatheter Aortic Valve Implantation (TAVI) is now considered an indispensable treatment strategy in high operative risk patients with severe, symptomatic aortic stenosis. However, conduction disturbances and the need for Permanent Pacemaker (PPM) implantation after TAVI with the CoreValve prosthesis still remain frequent. METHODS AND RESULTS: We aimed to evaluate the implantation depth, the incidence and predictors of new conduction disturbances, and the need for PPM implantation within the first month after TAVI, using the new Accutrak CoreValve delivery system (ACV), compared to the previous generation CoreValve (non-ACV). In 5 experienced TAVI-centers, a total of 120 consecutive non-ACV and 112 consecutive ACV patients were included (n=232). The mean depth of valve implantation (DVI) was 8.4+/-4.0mm in the non-ACV group and 7.1+/-4.0mm in the ACV group (p=0.034). The combined incidence of new PPM implantation and new LBBB was 71.2% in the non-ACV group compared to 50.5% in the ACV group (p=0.014). DVI (p=0.002), first degree AV block (p=0.018) and RBBB (p<0.001) were independent predictors of PPM implantation. DVI (p<0.001) and pre-existing first degree AV-block (p=0.021) were identified as significant predictors of new LBBB. CONCLUSION: DVI is an independent predictor of TAVI-related conduction disturbances and can be reduced by using the newer CoreValve Accutrak delivery system, resulting in a significantly lower incidence of new LBBB and new PPM implantation.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Lenders, Guy D.
Collas, Valerie
Hernandez, Jose Maria
Legrand, Victor ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie
Danenberg, Haim D.
den Heijer, Peter
Rodrigus, Inez E.
Paelinck, Bernard P.
Vrints, Christiaan J.
Bosmans, Johan M.
Language :
English
Title :
Depth of valve implantation, conduction disturbances and pacemaker implantation with CoreValve and CoreValve Accutrak system for Transcatheter Aortic Valve Implantation, a multi-center study.
Publication date :
2014
Journal title :
International Journal of Cardiology
ISSN :
0167-5273
eISSN :
1874-1754
Publisher :
Elsevier, Netherlands
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2014. Published by Elsevier Ireland Ltd.
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