Title :

Predictors of left ventricular outflow tract obstruction after transcatheter mitral valve replacement

Author(s) :

Yoon, Sung-Han [Auteur]
Bleiziffer, Sabine [Auteur]
Latib, Azeem [Auteur]
Eschenbach, Lena [Auteur]
Ancona, Marco [Auteur]
Vincent, Flavien [Auteur]
Kim, Won-Keun [Auteur]
Unbehaum, Axel [Auteur]
Asami, Masahiko [Auteur]
Dhoble, Abhijeet [Auteur]
Silaschi, Miriam [Auteur]
Frangieh, Antonio H. [Auteur]
Veulemans, Verena [Auteur]
Tang, Gilbert H L. [Auteur]
Kuwata, Shingo [Auteur]
Rampat, Rajiv [Auteur]
Schmidt, Tobias [Auteur]
Patel, Amisha J. [Auteur]
Nicz, Pedro Felipe Gomez [Auteur]
Nombela-Franco, Luis [Auteur]
Kini, Annapoorna [Auteur]
Kitamura, Mitsunobu [Auteur]
Sharma, Rahul [Auteur]
Chakravarty, Tarun [Auteur]
Hildick-Smith, David [Auteur]
Arnold, Martin [Auteur]
De Brito, Fabio Sandoli [Auteur]
Jensen, Christoph [Auteur]
Jung, Christian [Auteur]
Jilaihawi, Hasan [Auteur]
Smalling, Richard W. [Auteur]
Maisano, Francesco [Auteur]
Kasel, Albert Markus [Auteur]
Treede, Hendrik [Auteur]
Kempfert, Joerg [Auteur]
Pilgrim, Thomas [Auteur]
Kar, Saibal [Auteur]
Bapat, Vinayak [Auteur]
Whisenant, Brian K. [Auteur]
Van Belle, Eric [Auteur]
Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 [RNMCD]
Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (EGID) - U1011
Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (RNMCD) - U1011
Delgado, Victoria [Auteur]
Modine, Thomas [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U1171
Bax, Jeroen J. [Auteur]
Makkar, Raj R. [Auteur]

Journal title :

JACC. Cardiovascular interventions

Abbreviated title :

JACC Cardiovasc Interv

Volume number :

12

Pages :

182-193

Publication date :

2019-01-28

ISSN :

1876-7605

English keyword(s) :

transcatheter valve implantation
degenerated bioprosthesis
annuloplasty ring
mitral valve
mitral annular calcification
left ventricular outflow tract obstruction

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

The aim of this study was to evaluate the predictors of left ventricular outflow tract (LVOT) obstruction after transcatheter mitral valve replacement (TMVR). LVOT obstruction is a major concern with TMVR, but limited data ...
Show more >The aim of this study was to evaluate the predictors of left ventricular outflow tract (LVOT) obstruction after transcatheter mitral valve replacement (TMVR). LVOT obstruction is a major concern with TMVR, but limited data exist regarding its predictors and impact on outcomes. Patients with pre-procedural multidetector row computed tomography (MDCT) undergoing TMVR for failed mitral bioprosthetic valves (valve-in-valve), annuloplasty rings (valve-in-ring), and mitral annular calcification (valve-in-MAC) were included in this study. Echocardiographic and procedural characteristics were recorded, and comprehensive assessment with MDCT was performed to identify the predictors of LVOT obstruction (defined as an increment of mean LVOT gradient ≥10 mm Hg from baseline). The new LVOT (neo-LVOT) area left after TMVR was estimated by embedding a virtual valve into the mitral annulus on MDCT, simulating the procedure. Among 194 patients with pre-procedural MDCT undergoing TMVR (valve-in-valve, 107 patients; valve-in-ring, 50 patients; valve-in-MAC, 37 patients), LVOT obstruction was observed in 26 patients (13.4%), with a higher rate after valve-in-MAC than valve-in-ring and valve-in-valve (54.1% vs. 8.0% vs. 1.9%; p < 0.001). Patients with LVOT obstruction had significantly higher procedural mortality compared with those without LVOT obstruction (34.6% vs. 2.4%; p < 0.001). Receiver-operating characteristic curve analysis showed that an estimated neo-LVOT area ≤1.7 cm2 LVOT obstruction after TMVR was associated with higher procedural mortality. A small estimated neo-LVOT area was significantly associated with LVOT obstruction after TMVR and may help identify patients at high risk for LVOT obstruction.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
CNRS
Inserm
Institut Pasteur de Lille
Université de Lille

Collections :

• Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (RNMCD) - U1011

Submission date :

2019-11-27T14:33:42Z