TCT-825 Hemodynamic Valve Deterioration in Under- vs Over-Expanded Balloon Expandable Transcatheter Aortic Valves

Document Type

Conference Proceeding

Publication Date

10-29-2024

Publication Title

J Am Coll Cardiol

Keywords

aortic regurgitation, aortic valve, cohort analysis, conference abstract, follow up, hemodynamics, human, major clinical study, male, retrospective study, special situation for pharmacovigilance, surgery, transcatheter aortic valve implantation, valve deterioration, valvular heart disease

Abstract

Background: Non-nominal deployment of balloon-expandable valves (BEVs) is a common transcatheter aortic valve replacement (TAVR) practice. Effects of under- vs over-expansion of a BEV on hemodynamic valve deterioration (HVD) are not well studied. Methods: We conducted a single-center retrospective study of 175 patients who underwent TAVR with BEVs deployed at non-nominal and nominal volumes. Criteria of moderate HVD—changes from 1 month to 1 year after TAVR in peak and mean gradients and aortic valve area and dimensionless index (DI) as well as new aortic regurgitation—were studied. Results: There were no significant differences between the over- and under-expanded BEVs for any of the following criteria: 1-year AVA (P = 0.065), Δ AVA (P = 0.256), % Δ AVA (P = 0.156), 1-year peak gradient (P = 0.272) and mean gradient (P = 0.303), Δ mean gradient (P = 0.499), DI (P = 0.434), Δ DI (P = 0.382), % Δ DI (P = 0.379), AI (P = 0.373), and Δ AI (P = 0.416); Figure 1. In a linear regression analysis by actual volume subtracted from or added to nominal, there was no association with Δ AVA or Δ DI at 1-year (P = 0.55 and P = 0.85, respectively). [Formula presented] Conclusion: In this first in vivo analysis of non-nominally expanded BEVs and HVD, over-expanded and under-expanded BEVs appear to perform similarly out to 1 year. Larger studies with longer follow-up are needed. Categories: STRUCTURAL: Valvular Disease: Aortic.

Volume

84

Issue

18

First Page

B334

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