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Risk of Sinus Sequestration During Redo Transcatheter Aortic Valve Implantation: The Prevalence, Predictors, and Risk Stratification.
Higuchi, Ryosuke; Otaki, Yuka; Kanisawa, Mitsuru; Takamisawa, Itaru; Nanasato, Mamoru; Iguchi, Nobuo; Isobe, Mitsuaki.
Afiliación
  • Higuchi R; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. Electronic address: rhiguchi@shi.heart.or.jp.
  • Otaki Y; Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan.
  • Kanisawa M; Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan.
  • Takamisawa I; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
  • Nanasato M; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
  • Iguchi N; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
  • Isobe M; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
Am J Cardiol ; 211: 1-8, 2024 Jan 15.
Article en En | MEDLINE | ID: mdl-37884114
The number of patients who underwent transcatheter aortic valve implantation (TAVI) with the potential for reintervention is steadily increasing; however, there is a risk of sinus sequestration (SS) during a redo TAVI. The prevalence, predictors, and risk stratification of the risk for SS remain uncertain. We analyzed computed tomography acquired from 263 patients who underwent TAVI between 2021 and 2022: balloon-expandable valve (BEV) (71%) and self-expandable valve (SEV) (29%). Patients were considered at risk for SS if they met the following: (1) BEV frame > sinotubular junction (STJ) or SEV neocommissure greater than the STJ and (2) valve-to-STJ <2 mm. The risk of left, right, and any SS in 51%, 50%, and 65%, respectively, did not differ between BEV and SEV. The predictors of any SS were the height of the left and right coronary cusp (odds ratio [OR] 0.81 and 0.71, cutoff 18.6 and 19.2 mm, respectively) and STJ minus the annulus diameter (OR 0.65, cutoff 3.7 mm) in BEV, and STJ diameter (OR 0.47, cutoff 27.6 mm) in SEV. The number of predictors stratified the risk of any SS: low risk with BEV at 0 predictors (14% at risk of SS), intermediate risk at 1 predictor (65%), high risk at 2 or 3 predictors (81% and 95%), and low risk with SEV at 0 predictors (33%) versus high risk at 1 predictor (91%). In conclusion, 2/3 of patients who underwent TAVI were at risk of SS. The height of the coronary cusp and the STJ diameter were associated with and adequately stratified the risk of SS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Prótesis Valvulares Cardíacas / Reemplazo de la Válvula Aórtica Transcatéter Límite: Humans Idioma: En Revista: Am J Cardiol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Prótesis Valvulares Cardíacas / Reemplazo de la Válvula Aórtica Transcatéter Límite: Humans Idioma: En Revista: Am J Cardiol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos