Publication
Title
Depth of valve implantation, conduction disturbances and pacemaker implantation with CoreValve and CoreValve Accutrak system for Transcatheter Aortic Valve Implantation, a multi-center study
Author
Abstract
Background Transcatheter Aortic Valve Implantation (TAVI) is now considered an indispensable treatment strategy in high operative risk patients with severe, symptomatic aortic stenosis. However, conduction disturbances and the need for Permanent Pacemaker (PPM) implantation after TAVI with the CoreValve prosthesis still remain frequent. Methods and results We aimed to evaluate the implantation depth, the incidence and predictors of new conduction disturbances, and the need for PPM implantation within the first month after TAVI, using the new Accutrak CoreValve delivery system (ACV), compared to the previous generation CoreValve (non-ACV). In 5 experienced TAVI-centers, a total of 120 consecutive non-ACV and 112 consecutive ACV patients were included (n = 232). The mean depth of valve implantation (DVI) was 8.4 ± 4.0 mm in the non-ACV group and 7.1 ± 4.0 mm in the ACV group (p = 0.034). The combined incidence of new PPM implantation and new LBBB was 71.2% in the non-ACV group compared to 50.5% in the ACV group (p = 0.014). DVI (p = 0.002), first degree AV block (p = 0.018) and RBBB (p < 0.001) were independent predictors of PPM implantation. DVI (p < 0.001) and pre-existing first degree AV-block (p = 0.021) were identified as significant predictors of new LBBB. Conclusion DVI is an independent predictor of TAVI-related conduction disturbances and can be reduced by using the newer CoreValve Accutrak delivery system, resulting in a significantly lower incidence of new LBBB and new PPM implantation.
Language
English
Source (journal)
International journal of cardiology. - Amsterdam, 1981, currens
Publication
Amsterdam : 2014
ISSN
0167-5273
DOI
10.1016/J.IJCARD.2014.07.092
Volume/pages
176 :3 (2014) , p. 771-775
ISI
000343893300055
Pubmed ID
25147076
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Faculty/Department
Research group
Project info
Evaluation of percutaneous valves.
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identifier
Creation 29.09.2014
Last edited 09.10.2023
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