Outcomes of Patients with Severe Aortic Stenosis and Left Ventricular Obstruction Undergoing Transcatheter Aortic Valve Implantation
Section snippets
Methods
We retrospectively reviewed medical records of consecutive patients with severe AS who underwent TAVI at Cedars-Sinai medical center between January 2013 to December 2017 and included in our TAVI database. We excluded patients if (1) they had preexisting left-sided mechanical or bioprosthetic heart valve, (2) no available pre-TAVI transthoracic echocardiography (TTE) within 6 months prior to the procedure, or (3) if the pre-TAVI TTE image quality was poor. The remaining cohort constituted the
Results
We identified 1756 consecutive patients with severe AS who underwent TAVI during the study period. We excluded patients with prior left-sided mechanical or bioprosthetic heart valve replacement (N = 20), and 7 patients who did not have pre-TAVI TTE within 6 months before TAVI. The remaining 1729 patients constituted our study population. Baseline clinical, echocardiographic, MDCT, and periprocedural characteristics of the overall and matched populations are provided in Tables 1, 2, and 3,
Discussion
We conducted a retrospective observational study to evaluate the prevalence, clinical characteristics, and outcomes in patients with severe AS and concomitant LVO undergoing TAVI. To the best of our knowledge, this is the largest study looking at LVO in this population. The main findings of the present study were as follow: (1) The prevalence of LVO in patients with severe AS who underwent TAVI was low (1.8%). (2) The most common phenotypes of LV hypertrophy causing LVO were concentric LV
Disclosures
Dr. Makkar has received grant support from Edwards Lifesciences Corporation; is a consultant for Abbott Vascular, Cordis, and Medtronic, and holds equity in Entourage Medical. Dr. Chakravarty is a consultant, proctor, and speaker for Edwards Lifesciences and Medtronic; he is a consultant for Abbott Lifesciences, and he is a consultant and speaker for Boston Scientific. Other authors have no conflicts of interest to disclose.
Author Contribution
Danon Kaewkes: Conceptualization, Methodology, Formal analysis, Investigation, Writing -Original Draft. Tomoki Ochiai: Conceptualization, Methodology, Writing - Review & Editing. Nir Flint: Conceptualization, Writing - Review & Editing. Vivek Patel: Investigation, Writing - Review & Editing. Sahar Mahani: Investigation, Writing - Review & Editing. Matthias Raschpichler: Writing - Review & Editing. Sung-Han Yoon: Conceptualization, Writing - Review & Editing. Sabah Skaf: Writing - Review &
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Funding: None.