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Investigating Aortic Valve Calcification via Isolation and Culture of T Lymphocytes using Feeder Cells from Irradiated Buffy Coat
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Aortic valve calcification as a risk factor for major complications and reduced survival after transcatheter

Francesco Pollari1, Wolfgang Hitzl2, Ferdinand Vogt1

  • 1Cardiac surgery, Cardiovascular Center, Paracelsus Medical University-Klinikum Nürnberg, Nuremberg, Germany.

Journal of Cardiovascular Computed Tomography
|December 26, 2019
PubMed

Insights

Aortic valve calcification, particularly in the left ventricular outflow tract (LVOT), increases stroke and mortality risk after transcatheter aortic valve replacement (TAVR). This calcification is also linked to reduced long-term survival following the procedure.

Area of Science:

  • Cardiovascular Imaging and Intervention
  • Structural Heart Disease
  • Interventional Cardiology

Background:

  • Aortic valve calcification is a potential contributor to embolic stroke and subclinical valve thrombosis post-transcatheter aortic valve replacement (TAVR).
  • Assessing the impact of aortic valve calcification on in-hospital complications and survival after TAVR is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the association between aortic valve calcification and clinical outcomes, including stroke and mortality, in patients undergoing TAVR.
  • To determine the role of specific calcification patterns within the left ventricular outflow tract (LVOT) in predicting procedural and long-term results after TAVR.

Main Methods:

  • Retrospective analysis of preoperative contrast-enhanced multidetector computed tomography scans from 581 patients who underwent TAVR.
  • Quantification of calcium volume in each aortic cusp and LVOT.
  • Outcomes assessed using Valve Academic Research Consortium-2 (VARC-2) criteria.

Main Results:

  • Calcium load beneath the right coronary cusp in the LVOT was significantly associated with stroke and in-hospital mortality.
  • Total LVOT calcium volume correlated with in-hospital and 30-day mortality.
  • Factors associated with lower survival included LVOT calcium, male sex, lower baseline creatinine clearance, and severe baseline aortic regurgitation.

Conclusions:

  • Left ventricular outflow tract (LVOT) calcification is a significant predictor of increased peri-procedural stroke and mortality.
  • LVOT calcification is associated with diminished long-term survival following TAVR.
Abstract

Keywords:
CalcificationLong-term survivalStrokeTranscatheter aortic valve replacement

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