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Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities

The impact that post-dilatation has on the risk of experiencing conduction disorders after post-transcatheter aortic valve replacement with self-expanding valves (SE-TAVR) is unclear. We compared the rate of developing an atrioventricular (AV) high-grade conduction disorder and permanent pacemaker i...

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Autores principales: Massoullié, Grégoire, Combaret, Nicolas, Souteyrand, Géraud, Salazard, Jean Pascal, Pereira, Bruno, Jean, Frédéric, Motreff, Pascal, Taghli-Lamallem, Ouarda, Clerfond, Guillaume, Eschalier, Romain
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914379/
https://www.ncbi.nlm.nih.gov/pubmed/36766532
http://dx.doi.org/10.3390/diagnostics13030427
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author Massoullié, Grégoire
Combaret, Nicolas
Souteyrand, Géraud
Salazard, Jean Pascal
Pereira, Bruno
Jean, Frédéric
Motreff, Pascal
Taghli-Lamallem, Ouarda
Clerfond, Guillaume
Eschalier, Romain
author_facet Massoullié, Grégoire
Combaret, Nicolas
Souteyrand, Géraud
Salazard, Jean Pascal
Pereira, Bruno
Jean, Frédéric
Motreff, Pascal
Taghli-Lamallem, Ouarda
Clerfond, Guillaume
Eschalier, Romain
author_sort Massoullié, Grégoire
collection PubMed
description The impact that post-dilatation has on the risk of experiencing conduction disorders after post-transcatheter aortic valve replacement with self-expanding valves (SE-TAVR) is unclear. We compared the rate of developing an atrioventricular (AV) high-grade conduction disorder and permanent pacemaker implantation (PPI) in post-TAVR patients undergoing post-dilatation. We enrolled patients with severe symptomatic calcified aortic stenosis (CAS) who were undergoing SE-TAVR between 1 January 2016, and 19 April 2019 at a single French center. Of the 532 patients treated with SE-TAVR, 417 subjects (78.4%) received Corevalve Evolute R and 115 subjects (21.6%) received the latest-generation Corevalve Evolute Pro valve. In total, 104/532 patients (19.5%; 21.6% with Evolute R vs. 12.2% with Evolute Pro, p = 0.024) required post-dilatation. Evolut R was associated with an increased risk of post-dilatation (odds ratio 2.1 (1.01–4.33, p = 0.046)). We did not observe any post-dilatation increases in AV or in intra- and interventricular conduction disorders. In total, 26.1% of participants needed PPI within the first 30 post-procedure days (p = 0.449). Post-dilatation was not associated with a higher PPI risk (subdistribution hazard ratio 1.033 (0.726–1.471); p = 0.857). No significant differences existed between the groups in terms of one-year mortality (10.3%; p = 0.507). Post-dilatation in SE-TAVR did not increase the rate of electrical conduction disorders and PPI in the early implantation phase. The latest generation of SE-TAVR valves was associated with less need for post-dilatation.
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spelling pubmed-99143792023-02-11 Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities Massoullié, Grégoire Combaret, Nicolas Souteyrand, Géraud Salazard, Jean Pascal Pereira, Bruno Jean, Frédéric Motreff, Pascal Taghli-Lamallem, Ouarda Clerfond, Guillaume Eschalier, Romain Diagnostics (Basel) Article The impact that post-dilatation has on the risk of experiencing conduction disorders after post-transcatheter aortic valve replacement with self-expanding valves (SE-TAVR) is unclear. We compared the rate of developing an atrioventricular (AV) high-grade conduction disorder and permanent pacemaker implantation (PPI) in post-TAVR patients undergoing post-dilatation. We enrolled patients with severe symptomatic calcified aortic stenosis (CAS) who were undergoing SE-TAVR between 1 January 2016, and 19 April 2019 at a single French center. Of the 532 patients treated with SE-TAVR, 417 subjects (78.4%) received Corevalve Evolute R and 115 subjects (21.6%) received the latest-generation Corevalve Evolute Pro valve. In total, 104/532 patients (19.5%; 21.6% with Evolute R vs. 12.2% with Evolute Pro, p = 0.024) required post-dilatation. Evolut R was associated with an increased risk of post-dilatation (odds ratio 2.1 (1.01–4.33, p = 0.046)). We did not observe any post-dilatation increases in AV or in intra- and interventricular conduction disorders. In total, 26.1% of participants needed PPI within the first 30 post-procedure days (p = 0.449). Post-dilatation was not associated with a higher PPI risk (subdistribution hazard ratio 1.033 (0.726–1.471); p = 0.857). No significant differences existed between the groups in terms of one-year mortality (10.3%; p = 0.507). Post-dilatation in SE-TAVR did not increase the rate of electrical conduction disorders and PPI in the early implantation phase. The latest generation of SE-TAVR valves was associated with less need for post-dilatation. MDPI 2023-01-24 /pmc/articles/PMC9914379/ /pubmed/36766532 http://dx.doi.org/10.3390/diagnostics13030427 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Massoullié, Grégoire
Combaret, Nicolas
Souteyrand, Géraud
Salazard, Jean Pascal
Pereira, Bruno
Jean, Frédéric
Motreff, Pascal
Taghli-Lamallem, Ouarda
Clerfond, Guillaume
Eschalier, Romain
Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities
title Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities
title_full Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities
title_fullStr Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities
title_full_unstemmed Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities
title_short Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities
title_sort post-dilatation of new-generation self-expandable transcatheter aortic valves does not increase atrioventricular conduction abnormalities
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914379/
https://www.ncbi.nlm.nih.gov/pubmed/36766532
http://dx.doi.org/10.3390/diagnostics13030427
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