ArticleThe international journal of cardiovascular imaging2024
Impact of burden and distribution of aortic valve calcification on the hemodynamic performance and procedural outcomes of a self-expanding, intra-annular transcatheter aortic valve system.
Article in The international journal of cardiovascular imaging, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- One-Click CT-Based Pipeline for Regional Quantification of Aortic Valve Fibrocalcific Degeneration.Annals of biomedical engineering · 2026Article
- Transcatheter aortic valve implantation in a high-risk patient with critical aortic stenosis and severe valve calcification.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2026Article
- Procedural and Device Neutrality of Post-TAVI Renal Outcomes: A Multivariable Analysis of Valve Type, Size, and Anatomy.Journal of clinical medicine · 2026Article
- Interplay between parathyroid hormone concentration and valvular and aortic calcifications.Archives of medical science : AMS · 2026Article
- Co-Occurrence of Aortic Stenosis and Coronary Artery Disease: Facing Challenges Before, During, and After Transcatheter Aortic Valve Replacement.Journal of clinical medicine · 2025Review
- Paravalvular Leak in Transcatheter Aortic Valve Implantation: A Review of Current Challenges and Future Directions.Journal of cardiovascular development and disease · 2025Review
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Authors and funding
12 authors.
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Abstract
Aortic valve calcification (AVC) has been explored as a powerful predictor of procedural complications in patients undergoing transcatheter aortic valve implantation (TAVI). However, little evidence exists on its impact on intra-annular devices' performance. We aimed to investigate the impact of AVC burden and distribution pattern on the occurrence of paravalvular leak (PVL), conduction disturbances requiring permanent pacemaker implantation (PPI) and 30-day clinical outcomes in patients undergoing TAVI with a self-expanding, intra-annular device. According to AVC, 103 patients enrolled in a single medical centre from November 2019 to December 2022 were divided into tertiles. Valve Academic Research Consortium (VARC)-3 definitions were used to classify procedural complications and outcomes. Patients in the highest AVC tertile showed an increased occurrence of mild or more PVL and conduction disorders (p < 0.001 and p = 0.006). AVC tertiles (highest tertile) emerged as an independent predictor of PVL (OR 7.32, 95%CI 3.10-17.28, p < 0.001) and post-TAVI conduction disturbances (OR 3.73, 95%CI 1.31-10.60, p = 0.013) but not of PPI (OR 1.44, 95%CI 0.39-5.35, p = 0.579). Considering calcium distribution, ROC analyses revealed that annular AVC but not left ventricle outflow tract (LVOT) calcium burden significantly indicated the development of PVL (AUC 0.863, 0.77-0.93, p < 0.001) and conduction disorders/PPI (AUC 0.797, 0.70-0.89, p < 0.001 and 0.723, 0.58-0.86, p = 0.018, respectively). After adjustment for age and sex, the highest tertile remained an independent predictor of the 30-day composite outcome (death, myocardial infarction, stroke, major vascular complications, type 3/4 bleedings, acute kidney injury, PPI and ≥ moderate PVL) (OR 3.26; 95%CI 1.26-8.40, p = 0.014). A higher AVC is associated with an increased risk of PVL and conduction disturbances after TAVI with a self-expanding, intra-annular device. However, our findings suggest a minor role for LVOT calcification compared with annular AVC in the performance of this specific prosthesis.
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