TITLE

Impact of aortic valve calcification severity and impaired left ventricular function on 3-year results of patients undergoing transcatheter aortic valve replacement

AUTHOR(S)
Koos, Ralf; Reinartz, Sebastian; Mahnken, Andreas Horst; Herpertz, Ralf; Lotfi, Shahram; Autschbach, Rüdiger; Marx, Nikolaus; Hoffmann, Rainer
PUB. DATE
December 2013
SOURCE
European Radiology;Dec2013, Vol. 23 Issue 12, p3253
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objectives: To evaluate clinical pre-interventional predictors of 3-year outcome and mortality in high-risk patients with severe aortic valve stenosis treated with transcatheter aortic valve implantation (TAVI). Methods: Among 367 patients included in the Aachen TAVI registry, 76 patients with baseline dual-source computed tomography (DSCT) for the quantification of aortic valve calcification (AVC) and a 3-year follow-up were identified. Results: Survival at 30 days was 91 %, and it was 75 %, 66 % and 64 % at 1, 2 years and 3 years, respectively. Non-survivors at 3 years showed a significantly higher Agatston AVC score (2,854 ± 1,651) than survivors (1,854 ± 961, P = 0.007). Multivariate analysis including age, logistic EuroScore, glomerular filtration rate, Agatston AVC score, ejection fraction < 40 %, NYHA class, baseline medication, chronic lung disease and aortic regurgitation revealed that only the Agatston AVC score ( P = 0.03) and impaired left ventricular function ( P = 0.001) was significantly associated with mortality. Patients with Agatston AVC scores >2,000 had a significantly lower 3-year survival rate compared with patients with scores <2,000 (47 % vs 79 %, P = 0.004). Conclusions: In patients referred for TAVI, aortic valve calcification severity and impaired left ventricular function may serve as a predictor of long-term mortality. Therefore, AVC scores easily determined from pre-procedural CT datasets may be used for patient risk stratification. Key Points: • Dual-source CT provides excellent valve delineation before transcatheter aortic valve implantation (TAVI).• Aortic valve calcification assessed by cardiac CT predicts mortality in TAVI patients.• Aortic valve calcification scores can help stratify high-risk patients for TAVI.• Three-year results show good long-term outcome without evidence of structural valve deterioration.
ACCESSION #
91929032

 

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