Long-Term Clinical Outcomes and Carotid Ultrasound Follow-Up of Transcarotid TAVI. Prospective Single-Center Registry
Abstract
:1. Introduction
2. Materials and Methods
Statistical Methods
3. Results
3.1. Patients’ Characteristics
3.2. Procedural and In-Hospital Outcomes
3.2.1. Procedural Data
3.2.2. Periprocedural Outcomes
3.3. Follow-Up Outcomes
3.3.1. Clinical Outcomes
3.3.2. Echocardiographic Follow-Up
3.3.3. Carotid Doppler Ultrasound
4. Discussion
5. Conclusions
6. Limitations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Variables | TC-TAVI (n = 33) |
---|---|
Age, years | 77 (72–85) |
Males | 17 (51.5) |
BMI, kg/m2 | 28 (24.0–31.5) |
NYHA class | 3 (3–3) |
NYHA I | 0 (0) |
NYHA II | 0 (0) |
NYHA III | 27 (81.8) |
NYHA IV | 6 (18.2) |
EuroSCORE II, % | 6.12 (4.8–10.7) |
Cardiac comorbidities | |
Prior MI | 11 (33.3) |
Prior cardiac surgery | 10 (30.3) |
Prior PCI | 14 (42.4) |
Atrial fibrillation | 9 (27.3) |
Pacemaker | 1 (3.0) |
Hypertension | 33 (100) |
Other comorbidities | |
Dyslipidemia | 24 (72.7) |
Diabetes mellitus | 19 (57.6) |
COPD | 8 (24.2) |
PAD | 12 (36.4) |
DAD | 20 (60) |
Prior stroke | 1 (3.0) |
Prior TIA | 0 (0) |
Creatinine level, mg/dL | 1.08 (0.87–1.28) |
GFR, ml/min/1.73 m2 | 60.0 (44.5–70.0) |
Hematocrit, % | 38.9 (34.4–42.2) |
Hemoglobin, g/L | 12.9 (11.4–14.3) |
WBC, ×103/µL | 7.1 (5.7–8.4) |
MSCT parameters | |
LFA diameter, mm | 5.7 (4.8–6.8) |
RFA diameter, mm | 5.4 (4.9–7.1) |
LCCA diameter, mm | 6.2 (5.8–7.2) |
RCCA diameter, mm | 7.1 (5.9–8.1) |
BAV | 9 (27.2) |
LM height, mm | 12.7 (11.5–14.7) |
RCA height, mm | 17.7 (15.2–19.6) |
Annulus perimeter, mm | 444 (390.3–492.4) |
AVAA, mm2 | 76.6 (70.9–79.7) |
Pre-Procedural | Post-Procedural | Follow-Up | |
---|---|---|---|
LVEF, % | 50.0 (45–55) | 55.0 (50–60) | 55.0 (45–60) |
Pg max, mmHg | 69.0 (59–89) | 15 (12.6–18.7) * | 15 (12–19) * |
Pg mean, mmHg | 42.0 (35.5–54.5) | 8 (6–10) * | 8 (6–9) * |
Vmax, m/s | 4.1 (3.8–4.6) | 1.9 (1.7–2.1) * | 1.9 (1.7–2.0) * |
AVA, cm2 | 0.7 (0.6–0.8) | 1.8 (1.5–1.9) * | 1.8 (1.5–2.0) * |
PVL ≥ 2 grade | - | 2 (6.25) | 1 (3.2) |
Prosthesis Type | Prosthesis Size (n) | Sheath Size (n) | Sheatless (n) |
---|---|---|---|
MedtronicEvolut R | 26 (8) | 14 (2) | 6 |
MedtronicEvolut R | 29 (13) | 14 (5) | 8 |
MedtronicEvolut R | 34 (3) | 16 (1) | 2 |
Portico | 27 (1) | 16 (0) | 0 |
Edwards-Sapien 3 Ultra | 23 (3) | 14 (3) | 0 |
Edwards-Sapien 3 Ultra | 26 (4) | 14 (4) | 0 |
TC-TAVI (n = 33) | |
---|---|
Perioperative | |
Procedural success | 32 (96.9) |
Procedural mortality | 1 (3.0) |
Procedural time, min. | 65 (60–80) |
General anaesthesia | 33 (100) |
30-day outcomes | |
Death | 2 (6.1) |
TIA | 1 (3.0) |
Stroke | 0 (0) |
Myocardial infarction | 1 (3.0) |
Permanent pacemaker implantation | 5 (15.1) |
Long-term follow-up (19.5 ± 9.5 months) | |
Death | 7 (21.7) |
NYHA class | 1(1–2) |
NYHA I | 22 (71.0) |
NYHA II | 9 (29.0) |
NYHA III | 0 (0) |
NYHA IV | 0 (0) |
TIA | 2 (6.1) |
Stroke | 2 (6.1) |
Re-hospitalization | 4 (12.2) |
Carotid Doppler ultrasound | |
LCCA PSV, cm/s | 71.6 (61.2–86.7) |
LCCA EDV, cm/s | 9.1 (8.3–14.1) |
RCCA PSV, cm/s | 70.6 (61.8–83.1) |
RCCA EDV, cm/s | 10.1 (3.2–16.9) |
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Hudziak, D.; Hajder, A.; Gocol, R.; Malinowski, M.; Kazmierski, M.; Morkisz, L.; Ciosek, J.; Wanha, W.; Jarosinski, G.; Parma, R.; et al. Long-Term Clinical Outcomes and Carotid Ultrasound Follow-Up of Transcarotid TAVI. Prospective Single-Center Registry. J. Clin. Med. 2021, 10, 1499. https://doi.org/10.3390/jcm10071499
Hudziak D, Hajder A, Gocol R, Malinowski M, Kazmierski M, Morkisz L, Ciosek J, Wanha W, Jarosinski G, Parma R, et al. Long-Term Clinical Outcomes and Carotid Ultrasound Follow-Up of Transcarotid TAVI. Prospective Single-Center Registry. Journal of Clinical Medicine. 2021; 10(7):1499. https://doi.org/10.3390/jcm10071499
Chicago/Turabian StyleHudziak, Damian, Adrianna Hajder, Radoslaw Gocol, Marcin Malinowski, Maciej Kazmierski, Lukasz Morkisz, Joanna Ciosek, Wojciech Wanha, Grzegorz Jarosinski, Radoslaw Parma, and et al. 2021. "Long-Term Clinical Outcomes and Carotid Ultrasound Follow-Up of Transcarotid TAVI. Prospective Single-Center Registry" Journal of Clinical Medicine 10, no. 7: 1499. https://doi.org/10.3390/jcm10071499