Related Experiment Video
Updated: Jan 8, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Impact of Basal Septal Bulge on Conduction Disturbance After Transcatheter Aortic Valve Replacement Using ACURATE
Yoichi Sugiyama1,2, Noriaki Moriyama1, Hirokazu Miyashita1
1Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura City, Kanagawa, Japan.
Background:
New-onset conduction disturbance (CD) is a common complication of transcatheter aortic valve replacement (TAVR). Recently, basal septal bulge (BSB) has been reported as a predictor of CD. However, the impact of BSB on CD using ACURATE neo/neo2 remains unclear. We hypothesized that the left bundle branch could be damaged in patients with large BSB even by low radial force. This study investigated the predictors of CD after TAVR using ACURATE neo/neo2 and the impact of BSB on CD.
Methods:
We retrospectively analyzed 518 patients who underwent TAVR with ACURATE neo/neo2 in a single center. New-onset CD was defined as 30-day new permanent pacemaker implantation or new left bundle branch block lasting until discharge. The endpoints were the predictors of CD and the effect of BSB.
Results:
The incidence of CD was 11.0%. Multivariate analysis showed that complete right bundle branch block (odds ratio [OR]: 3.45; 95% CI: 1.63-7.30), membranous septum length <2 mm (OR: 2.14; 95% CI: 1.19-3.85), and BSB ≥3 mm (OR: 2.17; 95% CI: 1.22-3.86) were independent baseline predictors of CD. Postdilatation was the sole procedural predictor (OR: 2.28; 95% CI: 1.03-5.02). The risk of CD could be stratified according to the number of baseline predictors in patients with BSB ≥3 mm (0: 9.5%, 1: 26.1%, 2: 66.7%, p < 0.0001).
Conclusions:
BSB was significantly associated with CD in ACURATE neo/neo2, and CD risk could be stratified using baseline factors in patients with large BSB. These findings might be beneficial for periprocedural management and TAVR strategy.
More Related Videos
08:31A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
08:00Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter
Published on: June 15, 2015
Related Concept Videos
Aortic Regurgitation I: Introduction
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic Regurgitation III: Medical Management
Mitral Regurgitation I: Introduction
Mitral Valve Prolapse II: Assessment and Management
Mitral Stenosis II: Clinical features and Diagnostic Tests