In:
Open Heart, BMJ, Vol. 9, No. 2 ( 2022-07), p. e001995-
Abstract:
This study evaluates predictors of conduction abnormalities (CA) following transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic valves (BAV). Background TAVI is associated with CA that commonly necessitate a permanent pacemaker. Predictors of CA are well established among patients with tricuspid aortic valves but not in those with BAV. Methods This is a single-centre, retrospective, observational study of patients with BAV treated with TAVI. Pre-TAVI ECG and CT scans and procedural characteristics were evaluated in 58 patients with BAV. CA were defined as a composite of high-degree atrioventricular block, new left bundle branch block with a QRS 〉 150 ms or PR 〉 240 ms and right bundle branch block with new PR prolongation or change in axis. Predictors of CA were identified using regression analysis and optimum cut-off values determined using area under the receiver operating characteristic curve analysis. Results CA occurred in 35% of patients. Bioprosthesis implantation depth, the difference between membranous septum (MS) length and implantation depth ( δ MSID) and device landing zone (DLZ) calcification adjacent to the MS were identified as univariate predictors of CA. The optimum cut-off for δ MSID was 1.25 mm. Using this cut-off, low δ MSID and DLZ calcification adjacent to MS predicted CA, adjusted OR 8.79, 95% CI 1.88 to 41.00; p=0.01. Eccentricity of the aortic valve annulus, type of BAV and valve calcium quantity and distribution did not predict CA. Conclusions In BAV patients undergoing TAVI, short δ MSID and DLZ calcification adjacent to MS are associated with an increased risk of CA.
Type of Medium:
Online Resource
ISSN:
2053-3624
DOI:
10.1136/openhrt-2022-001995
Language:
English
Publisher:
BMJ
Publication Date:
2022
detail.hit.zdb_id:
2747269-3
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