TCT-825 Hemodynamic Valve Deterioration in Under- vs Over-Expanded Balloon Expandable Transcatheter Aortic Valves
Recommended Citation
Andrews T, McBride P, Abdelhai O, Fang J, Giustino G, Engel Gonzalez P, Villablanca P, O'Neill B, O'Neill W, Zweig B, Lee J, Frisoli T. TCT-825 Hemodynamic Valve Deterioration in Under- vs Over-Expanded Balloon Expandable Transcatheter Aortic Valves. J Am Coll Cardiol 2024; 84(18):B334.
Document Type
Conference Proceeding
Publication Date
10-29-2024
Publication Title
J Am Coll Cardiol
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
