TY - JOUR
T1 - Anatomic and procedural associations of transcatheter heart valve displacement following Evolut R implantation
AU - Hachinohe, Daisuke
AU - Latib, Azeem
AU - Laricchia, Alessandra
AU - Demir, Ozan M.
AU - Agricola, Eustachio
AU - Romano, Vittorio
AU - Del Sole, Paolo Alberto
AU - Leone, Pier Pasquale
AU - Ancona, Marco B.
AU - Mangieri, Antonio
AU - Regazzoli, Damiano
AU - Giannini, Francesco
AU - Mitomo, Satoru
AU - Monaco, Fabrizio
AU - Buzzatti, Nicola
AU - Montorfano, Matteo
AU - Colombo, Antonio
N1 - Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2019/2/15
Y1 - 2019/2/15
N2 - Objectives: This study aimed to predict the displacement of self-expanding transcatheter heart valves (THV) during final deployment. Background: Accurate device positioning during transcatheter aortic valve implantation (TAVI) is crucial for optimal results. Methods: At our institution, 103 patients who underwent transfemoral TAVI with Evolut R were retrospectively identified. Multiple linear regression models were created, and a predictor equation was built to quantify the factors that may affect THV behavior. Results: Multiple linear regression analysis for THV displacement on the left coronary cusp (LCC) identified the angle between the THV and the ascending aorta (ATA), predilation, and less operator experience as independent predictors of upward displacement, whereas estimated glomerular filtration rate (eGFR) was inversely related with THV behavior (95% confidence interval: 0.219 to 0.340, 0.447 to 2.092, 0.165 to 1.757, and −0.053 to −0.011, respectively). Predictors of THV displacement on the noncoronary cusp side could not be identified using this model. Conclusions: The ATA at the point of recapture, predilation, and less operator experience were independent predictors of upward displacement of THV on the LCC side. eGFR was an independent predictor of THV downward displacement on the LCC side. Of them, the ATA was the strongest predictor. Physicians may need to adjust this angle adequately before deployment to achieve the appropriate position.
AB - Objectives: This study aimed to predict the displacement of self-expanding transcatheter heart valves (THV) during final deployment. Background: Accurate device positioning during transcatheter aortic valve implantation (TAVI) is crucial for optimal results. Methods: At our institution, 103 patients who underwent transfemoral TAVI with Evolut R were retrospectively identified. Multiple linear regression models were created, and a predictor equation was built to quantify the factors that may affect THV behavior. Results: Multiple linear regression analysis for THV displacement on the left coronary cusp (LCC) identified the angle between the THV and the ascending aorta (ATA), predilation, and less operator experience as independent predictors of upward displacement, whereas estimated glomerular filtration rate (eGFR) was inversely related with THV behavior (95% confidence interval: 0.219 to 0.340, 0.447 to 2.092, 0.165 to 1.757, and −0.053 to −0.011, respectively). Predictors of THV displacement on the noncoronary cusp side could not be identified using this model. Conclusions: The ATA at the point of recapture, predilation, and less operator experience were independent predictors of upward displacement of THV on the LCC side. eGFR was an independent predictor of THV downward displacement on the LCC side. Of them, the ATA was the strongest predictor. Physicians may need to adjust this angle adequately before deployment to achieve the appropriate position.
KW - TAVI
KW - TAVR
KW - aortic stenosis
KW - displacement
KW - self-expanding
KW - transcatheter aortic valve implantation
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U2 - 10.1002/ccd.27827
DO - 10.1002/ccd.27827
M3 - Article
C2 - 30286515
AN - SCOPUS:85054598413
SN - 1522-1946
VL - 93
SP - 522
EP - 529
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 3
ER -