Procedural Results of Patients Undergoing Transcatheter Aortic Valve Implantation With Aortic Annuli Diameter ≥26 mm: insights from the German Aortic Valve Registry
Section snippets
Methods
The German Aortic Valve Registry (GARY) is a large, prospective, multicenter (78 sides) registry that monitors quality and outcomes in interventional and surgical aortic valve procedures all across Germany. Initiated in 2010, the all-comers registry collects data up to 5 years after the index procedure. Patient participation is voluntary, and the study design has been described in detail previously.7 Standardized electronic case report forms are used to collect baseline information and
Results
During the observation period from 2011 to 2017, valve implantations in extra-large anatomies increased steadily. Overall, a balloon-expandable ES valve was chosen in 311 patients (61.1%), and 198 patients (38.9%) received an MCV (Figure 2). Patients were in their early eighties (large: 80.4 years vs extra-large: 80.3 years, p = 0.787) and predominantly male (large: 92.6% vs extra-large: 91.9%, p = 0.564). Baseline characteristics after propensity score weighting were comparable, except for the
Discussion
Patients with large and extra-large aortic annulus anatomy who underwent TAVI may pose a special task to the interventional team because of the size limitations of currently commercially available transcatheter heart valves. Our study could show that patients presenting with an extra-large anatomy (aortic annulus diameter >29 mm for ES; >30 mm for MCV) have an increased risk for procedure-associated complications and impaired hemodynamic outcome, whereas in-hospital and 30-day mortality are not
Disclosures
Drs. Piayda and Zeus report statistical analysis was provided by German Center for Cardiovascular Disease. Dr. Frerker reports a relation with Universitätsklinikum Schleswig-Holstein that includes consulting or advisory and has received speaker fees from Medtronic, Edwards Lifesciences, Boston Scientific, and Abbott. Dr. Bleiziffer reports a relation with Heart and Diabetes Center North Rhine-Westphalia that includes consulting or advisory and has received speaker fees from Medtronic and Boston
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Drs. Zeus and Mehdiani contributed equally to this work.