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Calcium score association with paravalvular leakage in patients who underwent TAVR, the Mexican values
Jhonathan Uribe-Gonzalez1,2,3, Daniela L Leocachin-Parra2,3, Jorge Torres-Rosales2,3
1Departamento de Cardiología Intervencionista, Servicio de Cardiología, American British Cowdray Hospital, Ciudad de México, México.
Objective:
The objective is to determinate the association between the degree of aortic valve calcification and the presence of paravalvular leakage (PVL) in Mexican patients who underwent transcatheter aortic valve replacement (TAVR).
Methods:
We conducted a retrospective, analytic, cohort. Pooled data were retrospectively analyzed from the patient's files from January 2014 to July 2022. With a median follow-up of 6 months.
Results:
We included 83 patients. 31 (37.3%) developed residual PVL. Several factors as male gender (men 58.1% versus women 41.9% p = 0.01), higher gradients previous TAVR (mean 57 mmHg in the group with versus mean 53 mmHg in the group without PVL, p = 0.01), bigger annulus diameters and perimeters as well as reduce left ventricular ejection fraction and a degree of aortic regurgitation previous TAVR were present more frequently in the group of residual PVL. Aortic valve calcification was the only predictor after the bivariate and multivariate analysis that showed an association with the presence of PVL after TAVR. The calculated cut-off value of calcium score was 2970 Agatston units, with a sensitivity of 70% and a specificity of 60% as a predictor for PVL.
Conclusions:
The results are consistent with the previous data and there are no greater differences in the Mexican population. The severity of the aortic valve calcification is an independent predictor of PVL in patients who underwent TAVR.
Insights
The severity of aortic valve calcification predicts paravalvular leakage (PVL) after transcatheter aortic valve replacement (TAVR). Higher calcification scores increase PVL risk in Mexican patients undergoing TAVR.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Imaging
Background:
- Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
- Paravalvular leakage (PVL) is a known complication following TAVR.
- Predictors of PVL are crucial for improving patient outcomes.
Purpose of the Study:
- To determine the association between aortic valve calcification severity and PVL in Mexican patients.
- To identify calcification as a predictor for PVL post-TAVR.
Main Methods:
- Retrospective analysis of 83 Mexican patients undergoing TAVR from January 2014 to July 2022.
- Median follow-up of 6 months.
- Bivariate and multivariate analyses to identify predictors of PVL.
Main Results:
- 37.3% of patients developed residual PVL.
- Aortic valve calcification was the sole independent predictor of PVL after TAVR.
- A calcification score cut-off of 2970 Agatston units predicted PVL with 70% sensitivity and 60% specificity.
Conclusions:
- Aortic valve calcification severity is an independent predictor of PVL in Mexican patients post-TAVR.
- Findings are consistent with previous international data.
- Calcification assessment may aid in pre-procedural risk stratification for PVL.
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