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The Impact of Aortic Valvular Calcium on Transcatheter Heart Valve Distortion

Akihiro Nakajima1, Toru Naganuma1,2, Haruhito Yuki1

  • 1Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan.

Journal of Interventional Cardiology
|January 27, 2021
PubMed

Insights

Eccentric calcification in aortic valves leads to transcatheter heart valve (THV) distortion. However, this distortion did not impact clinical outcomes or echo parameters in patients with severe aortic stenosis.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Eccentric calcification of the aortic valve is a common finding in patients undergoing transcatheter heart valve (THV) implantation.
  • The impact of eccentric calcification on THV distortion and subsequent clinical outcomes remains incompletely understood.

Purpose of the Study:

  • To examine the association between eccentric aortic valve calcification and THV distortion.
  • To evaluate the influence of THV distortion on echocardiographic parameters and clinical outcomes following THV implantation.

Main Methods:

  • A cohort of 118 patients with symptomatic severe aortic stenosis undergoing THV implantation were analyzed.
  • Multislice computed tomography (MSCT) and transthoracic echocardiogram (TTE) were used to assess valve calcification (Delta calcium score, ΔCS) and THV distortion (valve distortion score, VDS).
  • Patients were stratified into noneccentric and eccentric calcification groups based on ΔCS.

Main Results:

  • Eccentric calcification was significantly associated with higher VDS (1.73 ± 0.76 mm) compared to noneccentric calcification (1.31 ± 0.82 mm) (p=0.004).
  • VDS did not correlate with paravalvular leak (PVL) or aortic valvular mean pressure gradient (AVPG) at 30-day and 1-year follow-up.
  • No significant association was found between VDS and cumulative rates of all-cause death or rehospitalization at 2-year follow-up.

Conclusions:

  • Eccentric aortic valve calcification is a predictor of longitudinal THV distortion.
  • THV distortion, despite being influenced by eccentric calcification, did not adversely affect midterm clinical outcomes, including PVL, AVPG, or adverse events.
Abstract

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