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RESEARCH PRODUCT
Predictive Factors, Management, and Clinical Outcomes of Coronary Obstruction Following Transcatheter Aortic Valve Implantation
Paul T.l. ChiamRaquel Del ValleAsim N. CheemaFernando A. CuraJosep Rodés-cabauJorge Salgado-fernándezCorrado TamburinoMarco BarbantiMarco BarbantiSergio CánovasRaj MakkarAlan ZajariasJean Michel ParadisAntonio DagerSusheel KodaliLuis Nombela-francoMarina UrenaSam RadhakrishnanEric LaroseSamir R. KapadiaHenrique Barbosa RibeiroJonathon LeipsicMarc RuelAugusto D. PichardSergio G. PasianJames L. VelianouGanesh ManoharanE. Murat TuzcuStamatios LerakisRogério Sarmento-leiteMauricio G. CohenFabio Sandoli De BritoHasan JilaihawiVasilis BabaliarosGonzalo PradasEric DumontIgnacio J. Amat-santosMartin B. LeonJohn G. WebbHadi ToegPeter De JaegereRaúl MorenoTarun ChakravartyMarco Antonio Perinsubject
medicine.medical_specialtyPercutaneous aortic valve replacementbusiness.industrymedicine.medical_treatmentPercutaneous coronary interventionSurgeryLeft coronary arteryCoronary occlusionRight coronary arterymedicine.arteryInternal medicineCohortmedicineCardiologyCardiology and Cardiovascular MedicinebusinessComplicationTIMIdescription
Objectives This study sought to evaluate the main baseline and procedural characteristics, management, and clinical outcomes of patients from a large cohort of patients undergoing transcatheter aortic valve implantation (TAVI) who suffered coronary obstruction (CO). Background Very little data exist on CO following TAVI. Methods This multicenter registry included 44 patients who suffered symptomatic CO following TAVI of 6,688 patients (0.66%). Pre-TAVI computed tomography data was available in 28 CO patients and in a control group of 345 patients (comparisons were performed including all patients and a cohort matched 1:1 by age, sex, previous coronary artery bypass graft, transcatheter valve type, and size). Results Baseline and procedural variables associated with CO were older age (p Conclusions Symptomatic CO following TAVI was a rare but life-threatening complication that occurred more frequently in women, in patients receiving a balloon-expandable valve, and in those with a previous surgical bioprosthesis. Lower-lying coronary ostium and shallow sinus of Valsalva were associated anatomic factors, and despite successful treatment, acute and late mortality remained very high, highlighting the importance of anticipating and preventing the occurrence of this complication.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2013-10-01 | Journal of the American College of Cardiology |