Impact of Cusp-Overlap View for TAVR with Self-Expandable Valves on 30-Day Conduction Disturbances

J Interv Cardiol. 2021 Apr 28:2021:9991528. doi: 10.1155/2021/9991528. eCollection 2021.

Abstract

Methods and results: We retrospectively compared 257 consecutive patients undergoing TAVR with self-expandable valves using either CON (n = 101) or COVL (n = 156) in four intermediate/low volume centers. There were no significant differences in baseline characteristics between the groups. The 30-day incidence of new-onset LBBB (12.9% vs. 5.8%; p=0.05) and PPMI rate (17.8% vs. 6.4%; p=0.004) was significantly lower when using the COVL implantation view. There was no difference between the CON and COVL groups in 30-day incidence of death (4.9% vs. 2.6%), any stroke (0% vs. 0.6%), and the need for surgical aortic valve replacement (0% for both groups).

Conclusion: Using the COVL view for implantation, we achieved a significant reduction of the LBBB and PPMI rate after TAVR in comparison with the traditional CON view, without compromising the TAVR outcomes when using self-expandable prostheses.

MeSH terms

  • Aged
  • Aortic Valve Stenosis* / diagnostic imaging
  • Aortic Valve Stenosis* / surgery
  • Aortic Valve* / diagnostic imaging
  • Aortic Valve* / surgery
  • Bundle-Branch Block* / etiology
  • Bundle-Branch Block* / therapy
  • Cardiac Catheterization / instrumentation
  • Cardiac Catheterization / methods
  • Equipment Design
  • Female
  • Heart Valve Prosthesis
  • Humans
  • Male
  • Outcome and Process Assessment, Health Care
  • Pacemaker, Artificial / statistics & numerical data*
  • Postoperative Complications / therapy*
  • Surgery, Computer-Assisted / instrumentation
  • Surgery, Computer-Assisted / methods
  • Transcatheter Aortic Valve Replacement* / adverse effects
  • Transcatheter Aortic Valve Replacement* / instrumentation
  • Transcatheter Aortic Valve Replacement* / methods