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Anatomical Annulus Predictors of New Permanent Pacemaker Implantation Risk After Balloon-Expandable Transcatheter Aortic Valve Implantation
by
Trani, Carlo
, Burzotta, Francesco
, Laezza, Domenico
, Romagnoli, Enrico
, Busco, Marco
, Pelargonio, Gemma
, Natale, Luigi
, Zito, Andrea
, Giambusso, Nicole
, Aurigemma, Cristina
, Bianchini, Emiliano
, Nesta, Marialisa
, Bruno, Piergiorgio
, Bianchini, Francesco
in
Aged
/ Aged, 80 and over
/ annulus eccentricity
/ Aortic Valve - diagnostic imaging
/ Aortic Valve - surgery
/ Aortic Valve Stenosis - surgery
/ Bundle-Branch Block - etiology
/ Bundle-Branch Block - therapy
/ calcium load
/ Female
/ Heart Valve Prosthesis
/ Humans
/ Male
/ Multidetector Computed Tomography - methods
/ Pacemaker, Artificial
/ permanent pacemaker implantation
/ Postoperative Complications - epidemiology
/ Prospective Studies
/ Prosthesis Design
/ Registries
/ Risk Factors
/ SAPIEN
/ transcatheter aortic valve implantation
/ Transcatheter Aortic Valve Replacement - adverse effects
/ Transcatheter Aortic Valve Replacement - methods
2024
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Anatomical Annulus Predictors of New Permanent Pacemaker Implantation Risk After Balloon-Expandable Transcatheter Aortic Valve Implantation
by
Trani, Carlo
, Burzotta, Francesco
, Laezza, Domenico
, Romagnoli, Enrico
, Busco, Marco
, Pelargonio, Gemma
, Natale, Luigi
, Zito, Andrea
, Giambusso, Nicole
, Aurigemma, Cristina
, Bianchini, Emiliano
, Nesta, Marialisa
, Bruno, Piergiorgio
, Bianchini, Francesco
in
Aged
/ Aged, 80 and over
/ annulus eccentricity
/ Aortic Valve - diagnostic imaging
/ Aortic Valve - surgery
/ Aortic Valve Stenosis - surgery
/ Bundle-Branch Block - etiology
/ Bundle-Branch Block - therapy
/ calcium load
/ Female
/ Heart Valve Prosthesis
/ Humans
/ Male
/ Multidetector Computed Tomography - methods
/ Pacemaker, Artificial
/ permanent pacemaker implantation
/ Postoperative Complications - epidemiology
/ Prospective Studies
/ Prosthesis Design
/ Registries
/ Risk Factors
/ SAPIEN
/ transcatheter aortic valve implantation
/ Transcatheter Aortic Valve Replacement - adverse effects
/ Transcatheter Aortic Valve Replacement - methods
2024
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Anatomical Annulus Predictors of New Permanent Pacemaker Implantation Risk After Balloon-Expandable Transcatheter Aortic Valve Implantation
by
Trani, Carlo
, Burzotta, Francesco
, Laezza, Domenico
, Romagnoli, Enrico
, Busco, Marco
, Pelargonio, Gemma
, Natale, Luigi
, Zito, Andrea
, Giambusso, Nicole
, Aurigemma, Cristina
, Bianchini, Emiliano
, Nesta, Marialisa
, Bruno, Piergiorgio
, Bianchini, Francesco
in
Aged
/ Aged, 80 and over
/ annulus eccentricity
/ Aortic Valve - diagnostic imaging
/ Aortic Valve - surgery
/ Aortic Valve Stenosis - surgery
/ Bundle-Branch Block - etiology
/ Bundle-Branch Block - therapy
/ calcium load
/ Female
/ Heart Valve Prosthesis
/ Humans
/ Male
/ Multidetector Computed Tomography - methods
/ Pacemaker, Artificial
/ permanent pacemaker implantation
/ Postoperative Complications - epidemiology
/ Prospective Studies
/ Prosthesis Design
/ Registries
/ Risk Factors
/ SAPIEN
/ transcatheter aortic valve implantation
/ Transcatheter Aortic Valve Replacement - adverse effects
/ Transcatheter Aortic Valve Replacement - methods
2024
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Anatomical Annulus Predictors of New Permanent Pacemaker Implantation Risk After Balloon-Expandable Transcatheter Aortic Valve Implantation
Journal Article
Anatomical Annulus Predictors of New Permanent Pacemaker Implantation Risk After Balloon-Expandable Transcatheter Aortic Valve Implantation
2024
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Overview
New-generation transcatheter heart valves have significantly improved technical success and procedural safety of transcatheter aortic valve implantation (TAVI) procedures; however, the incidence of permanent pacemaker implantation (PPI) remains a concern. This study aimed to assess the role of anatomic annulus features in determining periprocedural conduction disturbances leading to new PPI after TAVI using the last-generation Edwards SAPIEN balloon-expandable valves. In the context of a prospective single-center registry, we integrated the clinical and procedural predictors of PPI with anatomic data derived from multislice computed tomography. A total of 210 consecutive patients treated with balloon-expandable Edwards transcatheter heart valve were included in the study from 2015 to 2023. Technical success was achieved in 197 procedures (93.8%), and 26 patients (12.4%) required new PPI at the 30-day follow-up (median time to implantation 3 days). At the univariable logistic regression analysis, preprocedural right bundle branch block (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.01 to 4.97, p = 0.047), annulus eccentricity ≥0.25 (OR 5.43, 95% CI 2.21 to 13.36, p <0.001), calcium volume at annulus of the right coronary cusp >48 mm3 (OR 2.60, 95% CI 1.13 to 5.96, p = 0.024), and prosthesis implantation depth greater than membranous septum length (OR 2.17, 95% CI 1.10 to 4.28, p = 0.026) were associated with new PPI risk. In the multivariable analysis, preprocedural right bundle branch block (OR 2.81, 95% CI 1.01 to 7.85, p = 0.049), annulus eccentricity ≥0.25 (OR 4.14, 95% CI 1.85 to 9.27, p <0.001), and annulusright coronary cusp calcium >48 mm3 (OR 2.89, 95% CI 1.07 to 7.82, p = 0.037) were confirmed as independent predictors of new PPI. In conclusion, specific anatomic features of the aortic valve annulus might have an additive role in determining the occurrence of conduction disturbances in patients who underwent TAVI with balloon-expandable valves. This suggests the possibility to use multislice computed tomography to improve the prediction of post-TAVI new PPI risk.
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Publisher
Elsevier Inc
Subject
/ Aortic Valve - diagnostic imaging
/ Aortic Valve Stenosis - surgery
/ Bundle-Branch Block - etiology
/ Bundle-Branch Block - therapy
/ Female
/ Humans
/ Male
/ Multidetector Computed Tomography - methods
/ permanent pacemaker implantation
/ Postoperative Complications - epidemiology
/ SAPIEN
/ transcatheter aortic valve implantation
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