Related Experiment Video

Updated: Mar 11, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:04

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

673

Aortic Valve Calcium Score Spectrum Identifies Bimodal Outcomes for Transcatheter Aortic Valve Implantation: Insights

Yeela Talmor-Barkan1,2, Marco Barbanti3,4, Roberto Valvo4

  • 1Department of Cardiology Rabin Medical Centre Petach-Tikva Israel.

Journal of the American Heart Association
|March 10, 2026
PubMed

Insights

Aortic stenosis severity varies. Low aortic valve calcium scores (AVCS) indicate fibrosis and worse outcomes, while very-high AVCS suggest higher procedural risks. Both extremes impact 3-year mortality.

Area of Science:

  • Cardiology
  • Valvular Heart Disease
  • Medical Imaging

Background:

  • Degenerative calcification is the primary cause of severe aortic stenosis.
  • Some patients with severe aortic stenosis have low aortic valve calcium scores (AVCS), indicating heterogeneous disease processes.

Purpose of the Study:

  • To evaluate clinical characteristics and outcomes across the spectrum of aortic valve calcium scores (AVCS) in severe aortic stenosis patients.

Main Methods:

  • Retrospective analysis of 3766 patients with severe aortic stenosis from the AMTRAC registry (2013-2024).
  • Patients stratified into low, high, or very-high AVCS groups.
  • Primary endpoint: 3-year mortality; Secondary endpoints: periprocedural outcomes and post-transcatheter aortic valve implantation hemodynamics.

Main Results:

  • Low AVCS patients presented with low-gradient aortic stenosis and advanced symptoms.
  • Mortality showed a bimodal pattern: 30.5% (low AVCS), 26.5% (high AVCS), 31.3% (very-high AVCS) at 3 years.
  • Higher rates of moderate-to-severe paravalvular leak, stroke, and permanent pacemaker implantation were observed in very-high AVCS group.

Conclusions:

  • Low AVCS signifies a unique phenotype of fibrosis, advanced symptoms, and increased mortality.
  • Very-high AVCS is associated with greater procedural risks, bicuspid valves, and elevated mortality.
  • Findings challenge calcification-based criteria and support integrating fibrosis assessment into treatment strategies for aortic stenosis.
Abstract

Keywords:
aortic stenosisaortic valve calcium scoreparavalvular leaktranscatheter aortic valve implantation

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