PREDICTORS OF CARDIAC CONDUCTION DISTURBANCES AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION USING SELFEXPANDABLE VALVES

• DOI: 10.21608/asmj.2019.102912
• Publication Date: 2020-07-21T19:51:37Z
• Authors: Mahmoud Baraka; Ahmad Yousef; Diaa El-Din Kamal; Maiy El-Sayed
• Keywords: Cardiac valve

Background:The advent of transcatheter aortic valve implantation (TAVI) represented a paradigm shift for treating patients with severe symptomatic stenosis (AS) who are at high or prohibitive surgical risk.With the growing experience in this field, rate periprocedural complications has decreased over time and TAVI been increasingly performed minimalist approach, evolving into safe procedure predictable outcomes.However, unlike other procedural complications, incidence conduction disturbances which could be form bundle branch blocks, atrioventricular failed to decrease recent times, reports suggesting an increased risk associated use some newer-generation valves. Aim work: To determine predictors cardiac after implantation.Patients Methods: From January 2017 April 2019, we included 38 consecutive AS underwent using self-expandable valves (CoreValve Evolut R) balloon expandable Sapien XT Ain Shams University Hospitals.All were subjected electrocardiographic evaluation pre-and post-TAVI 30 days.Several parameters studied including preprocedural parameters: clinical, electrocardiographic, echocardiographic, CT derived parameters, type size valve, post-implantation dilatation, depth implantation.All quantitative indexed body surface area (BSA).Results: Conduction seen 16 (42.1%), 10 (26.3%) experienced left block (LBBB), 6 (15.8%) complete heart (CHB), only one them (2.6%) permanent CHB requiring pacemaker (PPI).Multivariate logistic regression analysis pre-procedural showed that presence basal septal calcification is most powerful independent predictor (OR: 98.73, 95% CI: 7.63 1278.23, p < 0.001).Multivariate relationship between membranous septum expressed percentage (DIMS) cut-off >75.00% 16.00, 2.12 120.65, 0.007).