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Predictive factors, management, and clinical outcomes of coronary obstruction following transcatheter aortic valve implantation: insights from a large multicenter registry

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dc.contributor.authorRibeiro, Henrique B.
dc.contributor.authorWebb, John G.
dc.contributor.authorMakkar, Raj R.
dc.contributor.authorCohen, Mauricio G.
dc.contributor.authorKapadia, Samir R.
dc.contributor.authorKodali, Susheel
dc.contributor.authorTamburino, Corrado
dc.contributor.authorBarbanti, Marco
dc.contributor.authorChakravarty, Tarun
dc.contributor.authorJilaihawu, Hasan
dc.contributor.authorParadis, Jean-Michel
dc.contributor.authorBrito, Fabio S. de
dc.contributor.authorCánovas López, Sergio
dc.contributor.authorCheema, Asim N.
dc.contributor.authorJaegere, Peter P. de
dc.contributor.authorValle, Raquel del
dc.contributor.authorChiam, Paul T. L.
dc.contributor.authorMoreno, Raúl
dc.contributor.authorPradas, Gonzalo
dc.contributor.authorRuel, Marc
dc.contributor.authorSalgado Fernández, Jorge
dc.contributor.authorSarmento-Leite, Rogerio
dc.contributor.authorToeg, Hadi D.
dc.contributor.authorVelianou, James L.
dc.contributor.authorZajarias, Alan
dc.contributor.authorBabaliaros, Vasilis
dc.contributor.authorCura, Fernando
dc.contributor.authorDager, Antonio E.
dc.contributor.authorManoharan, Ganesh
dc.contributor.authorLerakis, Stamatios
dc.contributor.authorPichard, Augusto D.
dc.contributor.authorRadhakrishnan, Sam
dc.contributor.authorPerin, Marco Antonio
dc.contributor.authorDumont, Eric
dc.contributor.authorLarose, Eric
dc.contributor.authorPasian, Sergio G.
dc.contributor.authorNombela-Franco, Luis
dc.contributor.authorUrena, Marina
dc.contributor.authorMurat Tuzcu, E.
dc.contributor.authorLeon, Martin B.
dc.contributor.authorAmat-Santos, Ignacio J.
dc.contributor.authorLeipsic, Jonathon
dc.contributor.authorRodés Cabau, Josep
dc.contributor.departmentCirugía, Pediatría y Obstetricia y Ginecología
dc.date.accessioned2025-02-26T07:08:56Z
dc.date.available2025-02-26T07:08:56Z
dc.date.issued2013-10-22
dc.description© 2013 American College of Cardiology Foundation. This document is the Published Manuscript, version of a Published Work that appeared in final form in Journal of the American College of Cardiology. To access the final edited and published work see https://doi.org/10.1016/j.jacc.2013.07.040
dc.description.abstractObjectives: This study sought to evaluate the main baseline and procedural characteristics, management, and clinical outcomes of patients from a large cohort of patients undergoing transcatheter aortic valve implantation (TAVI) who suffered coronary obstruction (CO). Background: Very little data exist on CO following TAVI. Methods: This multicenter registry included 44 patients who suffered symptomatic CO following TAVI of 6,688 patients (0.66%). Pre-TAVI computed tomography data was available in 28 CO patients and in a control group of 345 patients (comparisons were performed including all patients and a cohort matched 1:1 by age, sex, previous coronary artery bypass graft, transcatheter valve type, and size). Results: Baseline and procedural variables associated with CO were older age (p < 0.001), female sex (p < 0.001), no previous coronary artery bypass graft (p = 0.043), the use of a balloon-expandable valve (p = 0.023), and previous surgical aortic bioprosthesis (p = 0.045). The left coronary artery was the most commonly involved (88.6%). The mean left coronary artery ostia height and sinus of Valsalva diameters were lower in patients with obstruction than in control subjects (10.6 ± 2.1 mm vs. 13.4 ± 2.1 mm, p < 0.001; 28.1 ± 3.8 mm vs. 31.9 ± 4.1 mm, p < 0.001). Differences between groups remained significant after the case-matched analysis (p < 0.001 for coronary height; p = 0.01 for sinus of Valsalva diameter). Most patients presented with persistent severe hypotension (68.2%) and electrocardiographic changes (56.8%). Percutaneous coronary intervention was attempted in 75% of the cases and was successful in 81.8%. Thirty-day mortality was 40.9%. After a median follow-up of 12 (2 to 18) months, the cumulative mortality rate was 45.5%, and there were no cases of stent thrombosis or reintervention. Conclusions: Symptomatic CO following TAVI was a rare but life-threatening complication that occurred more frequently in women, in patients receiving a balloon-expandable valve, and in those with a previous surgical bioprosthesis. Lower-lying coronary ostium and shallow sinus of Valsalva were associated anatomic factors, and despite successful treatment, acute and late mortality remained very high, highlighting the importance of anticipating and preventing the occurrence of this complication.es
dc.formatapplication/pdfes
dc.format.extent11es
dc.identifier.citationJournal of the American College of Cardiology, 2013, Vol. 62, Issue 17, pp. 1552-1562
dc.identifier.doihttps://doi.org/10.1016/j.jacc.2013.07.040
dc.identifier.issnPrint: 0735-1097
dc.identifier.issnElectronic: 1558-3597
dc.identifier.urihttp://hdl.handle.net/10201/151082
dc.languageenges
dc.publisherElsevier
dc.relationSin financiación externa a la Universidades
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S0735109713029471
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectCoronary obstruction
dc.subjectCoronary occlusion
dc.subjectPercutaneous aortic valve replacement
dc.subjectPercutaneous coronary intervention
dc.subjectTranscatheter aortic valve implantation
dc.titlePredictive factors, management, and clinical outcomes of coronary obstruction following transcatheter aortic valve implantation: insights from a large multicenter registryes
dc.typeinfo:eu-repo/semantics/articlees
dspace.entity.typePublicationes
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