Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world

Takahide Arai, Thierry Lefèvre, Thomas Hovasse, Philippe Garot, Hakim Benamer, Thierry Unterseeh, Andrew K. Roy, Mauro Romano, Kentaro Hayashida, Yusuke Watanabe, Erik Bouvier, Marie Claude Morice, Bernard Chevalier

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives: Coronary obstruction (CO) is a rare but serious complication of transcatheter aortic valve implantation (TAVI). There are very limited data regarding CO following TAVI. The aim of this study was to evaluate the incidence and outcomes of CO after TAVI and identify the predictors including the valve type. Methods: Between October 2006 and March 2015, 1,203 TAVI cases were performed in our institution. Of them, 814 cases whose coronary height was measured using computed tomography for screening were analyzed in this study. Results: The Edwards SAPIEN/SAPIEN XT (S/XT) was used in 427 (52.4%) cases, the CoreValve in 265 (32.6%), and the S3 in 122 (15.0%). CO occurred in 8 (1.0%) cases, 1.6% with S/XT, 0.4% with CoreValve, and 0% with S3. All instances of CO occurred at the left coronary artery. The 30-day mortality was significantly higher in cases of CO (37.5% vs. 5.8%, P=0.010). The frequency of CO tended to be lower in recipients of the CoreValve (0.4%) and S3 (0%) compared with the S/XT (1.6%) (P=0.188 for CoreValve vs. S/XT, P=0.022 for S3 vs. S/XT). Conclusions: CO has poor outcomes and identification of patients at risk of CO to take preventive measures is crucial. The preliminary data showing that the occurrence of CO is low in patients receiving the S3 despite increased prosthesis height need further confirmation.

Original languageEnglish
JournalCatheterization and Cardiovascular Interventions
DOIs
Publication statusAccepted/In press - 2017

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Incidence
Prostheses and Implants
Coronary Vessels
Tomography
Mortality
Transcatheter Aortic Valve Replacement

Keywords

  • Coronary obstruction
  • Severe symptomatic aortic stenosis
  • Transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world. / Arai, Takahide; Lefèvre, Thierry; Hovasse, Thomas; Garot, Philippe; Benamer, Hakim; Unterseeh, Thierry; Roy, Andrew K.; Romano, Mauro; Hayashida, Kentaro; Watanabe, Yusuke; Bouvier, Erik; Morice, Marie Claude; Chevalier, Bernard.

In: Catheterization and Cardiovascular Interventions, 2017.

Research output: Contribution to journalArticle

Arai, T, Lefèvre, T, Hovasse, T, Garot, P, Benamer, H, Unterseeh, T, Roy, AK, Romano, M, Hayashida, K, Watanabe, Y, Bouvier, E, Morice, MC & Chevalier, B 2017, 'Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world', Catheterization and Cardiovascular Interventions. https://doi.org/10.1002/ccd.26982
Arai, Takahide ; Lefèvre, Thierry ; Hovasse, Thomas ; Garot, Philippe ; Benamer, Hakim ; Unterseeh, Thierry ; Roy, Andrew K. ; Romano, Mauro ; Hayashida, Kentaro ; Watanabe, Yusuke ; Bouvier, Erik ; Morice, Marie Claude ; Chevalier, Bernard. / Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world. In: Catheterization and Cardiovascular Interventions. 2017.
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abstract = "Objectives: Coronary obstruction (CO) is a rare but serious complication of transcatheter aortic valve implantation (TAVI). There are very limited data regarding CO following TAVI. The aim of this study was to evaluate the incidence and outcomes of CO after TAVI and identify the predictors including the valve type. Methods: Between October 2006 and March 2015, 1,203 TAVI cases were performed in our institution. Of them, 814 cases whose coronary height was measured using computed tomography for screening were analyzed in this study. Results: The Edwards SAPIEN/SAPIEN XT (S/XT) was used in 427 (52.4{\%}) cases, the CoreValve in 265 (32.6{\%}), and the S3 in 122 (15.0{\%}). CO occurred in 8 (1.0{\%}) cases, 1.6{\%} with S/XT, 0.4{\%} with CoreValve, and 0{\%} with S3. All instances of CO occurred at the left coronary artery. The 30-day mortality was significantly higher in cases of CO (37.5{\%} vs. 5.8{\%}, P=0.010). The frequency of CO tended to be lower in recipients of the CoreValve (0.4{\%}) and S3 (0{\%}) compared with the S/XT (1.6{\%}) (P=0.188 for CoreValve vs. S/XT, P=0.022 for S3 vs. S/XT). Conclusions: CO has poor outcomes and identification of patients at risk of CO to take preventive measures is crucial. The preliminary data showing that the occurrence of CO is low in patients receiving the S3 despite increased prosthesis height need further confirmation.",
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T1 - Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world

AU - Arai, Takahide

AU - Lefèvre, Thierry

AU - Hovasse, Thomas

AU - Garot, Philippe

AU - Benamer, Hakim

AU - Unterseeh, Thierry

AU - Roy, Andrew K.

AU - Romano, Mauro

AU - Hayashida, Kentaro

AU - Watanabe, Yusuke

AU - Bouvier, Erik

AU - Morice, Marie Claude

AU - Chevalier, Bernard

PY - 2017

Y1 - 2017

N2 - Objectives: Coronary obstruction (CO) is a rare but serious complication of transcatheter aortic valve implantation (TAVI). There are very limited data regarding CO following TAVI. The aim of this study was to evaluate the incidence and outcomes of CO after TAVI and identify the predictors including the valve type. Methods: Between October 2006 and March 2015, 1,203 TAVI cases were performed in our institution. Of them, 814 cases whose coronary height was measured using computed tomography for screening were analyzed in this study. Results: The Edwards SAPIEN/SAPIEN XT (S/XT) was used in 427 (52.4%) cases, the CoreValve in 265 (32.6%), and the S3 in 122 (15.0%). CO occurred in 8 (1.0%) cases, 1.6% with S/XT, 0.4% with CoreValve, and 0% with S3. All instances of CO occurred at the left coronary artery. The 30-day mortality was significantly higher in cases of CO (37.5% vs. 5.8%, P=0.010). The frequency of CO tended to be lower in recipients of the CoreValve (0.4%) and S3 (0%) compared with the S/XT (1.6%) (P=0.188 for CoreValve vs. S/XT, P=0.022 for S3 vs. S/XT). Conclusions: CO has poor outcomes and identification of patients at risk of CO to take preventive measures is crucial. The preliminary data showing that the occurrence of CO is low in patients receiving the S3 despite increased prosthesis height need further confirmation.

AB - Objectives: Coronary obstruction (CO) is a rare but serious complication of transcatheter aortic valve implantation (TAVI). There are very limited data regarding CO following TAVI. The aim of this study was to evaluate the incidence and outcomes of CO after TAVI and identify the predictors including the valve type. Methods: Between October 2006 and March 2015, 1,203 TAVI cases were performed in our institution. Of them, 814 cases whose coronary height was measured using computed tomography for screening were analyzed in this study. Results: The Edwards SAPIEN/SAPIEN XT (S/XT) was used in 427 (52.4%) cases, the CoreValve in 265 (32.6%), and the S3 in 122 (15.0%). CO occurred in 8 (1.0%) cases, 1.6% with S/XT, 0.4% with CoreValve, and 0% with S3. All instances of CO occurred at the left coronary artery. The 30-day mortality was significantly higher in cases of CO (37.5% vs. 5.8%, P=0.010). The frequency of CO tended to be lower in recipients of the CoreValve (0.4%) and S3 (0%) compared with the S/XT (1.6%) (P=0.188 for CoreValve vs. S/XT, P=0.022 for S3 vs. S/XT). Conclusions: CO has poor outcomes and identification of patients at risk of CO to take preventive measures is crucial. The preliminary data showing that the occurrence of CO is low in patients receiving the S3 despite increased prosthesis height need further confirmation.

KW - Coronary obstruction

KW - Severe symptomatic aortic stenosis

KW - Transcatheter aortic valve implantation

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DO - 10.1002/ccd.26982

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JO - Catheterization and Cardiovascular Interventions

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SN - 1522-1946

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