TY - JOUR
T1 - Relationship between Invasive and Echocardiographic Transvalvular Gradients after Transcatheter Aortic Valve Replacement
AU - Aalaei-Andabili, Seyed Hossein
AU - Park, Ki E.
AU - Choi, Calvin Y.
AU - Manning, Eddie W.
AU - Stinson, Wade W.
AU - Van Woerkom, Ryan
AU - Pilgrim, Thomas
AU - Kumbhani, Dharam J.
AU - Bavry, Anthony A.
N1 - Funding Information:
No funding or sponsorship was received for this study or publication of this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Seyed Hossein Aalaei-Andabili, Ki Park, Calvin Choi, Eddie Manning, Wade Stinson, Ryan Van Woerkom, Thomas Pilgrim, and Dharam Kumbhani have nothing to disclose. Anthony A. Bavry has received honoraria from the American College of Cardiology and Edwards Lifesciences. Anthony A. Bavry is a member of the journal’s Editorial Board. The University of Florida Institutional Review Board approved this retrospective study. The study was performed in accordance with the Declaration of Helsinki of 1964 and its later amendments. Informed consent was obtained from all patients for being included in the study. The datasets generated during and/or analyzed during the current study are available, in anonymized form to protect patient privacy, from the corresponding author on reasonable request.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Introduction: Lower transcatheter aortic valve replacement (TAVR) pressure gradients have been reported after implantation of self-expanding valves compared with balloon-expandable valves; however, there is a paucity of data on the relationship between invasively measured transvalvular pressure gradients and Doppler-derived measurements. Methods: From September 2013 to September 2018, patients with native aortic valve stenosis who had both intraoperative invasive and postoperative echocardiography transvalvular pressure gradients were included for analysis. We used parametric and nonparametric statistics to compare aortic gradients within and between groups. Results: Of 171 patients, 152 (88.9%) patients had TAVR with a balloon-expandable valve and 19 (11.1%) with a self-expanding valve. Among all patients, the invasive aortic gradient was 7.8 ± 3.2 mmHg and the Doppler-derived aortic gradient was 11.0 ± 4.5 mmHg (p < 0.001). Among those who received a balloon-expandable valve, the invasive aortic gradient was 7.5 ± 3 mmHg and the Doppler aortic gradient was 11.4 ± 4.5 mmHg (p < 0.001). In contrast, among patients who received a self-expanding valve, the invasive aortic gradient was 10.3 ± 3.4 mmHg and the Doppler aortic gradient was 8.5 ± 4.6 mmHg (p = 0.18). Conclusions: Balloon-expandable valves were associated with lower invasive measurements versus post-TAVR Doppler gradients, while results were inconclusive regarding self-expanding valves.
AB - Introduction: Lower transcatheter aortic valve replacement (TAVR) pressure gradients have been reported after implantation of self-expanding valves compared with balloon-expandable valves; however, there is a paucity of data on the relationship between invasively measured transvalvular pressure gradients and Doppler-derived measurements. Methods: From September 2013 to September 2018, patients with native aortic valve stenosis who had both intraoperative invasive and postoperative echocardiography transvalvular pressure gradients were included for analysis. We used parametric and nonparametric statistics to compare aortic gradients within and between groups. Results: Of 171 patients, 152 (88.9%) patients had TAVR with a balloon-expandable valve and 19 (11.1%) with a self-expanding valve. Among all patients, the invasive aortic gradient was 7.8 ± 3.2 mmHg and the Doppler-derived aortic gradient was 11.0 ± 4.5 mmHg (p < 0.001). Among those who received a balloon-expandable valve, the invasive aortic gradient was 7.5 ± 3 mmHg and the Doppler aortic gradient was 11.4 ± 4.5 mmHg (p < 0.001). In contrast, among patients who received a self-expanding valve, the invasive aortic gradient was 10.3 ± 3.4 mmHg and the Doppler aortic gradient was 8.5 ± 4.6 mmHg (p = 0.18). Conclusions: Balloon-expandable valves were associated with lower invasive measurements versus post-TAVR Doppler gradients, while results were inconclusive regarding self-expanding valves.
KW - Balloon-expanding valve
KW - Doppler aortic gradient
KW - Invasive aortic gradient
KW - Self-expanding valve
KW - TAVR
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U2 - 10.1007/s40119-020-00161-y
DO - 10.1007/s40119-020-00161-y
M3 - Article
C2 - 31970689
AN - SCOPUS:85102622203
SN - 2193-8261
VL - 9
SP - 201
EP - 206
JO - Cardiology and Therapy
JF - Cardiology and Therapy
IS - 1
ER -