Calcium Load in the Aortic Valve, Aortic Root, and Left Ventricular Outflow Tract and the Risk for a Periprocedural Stroke
(2022) In Structural Heart 6(4).- Abstract
Background: Periprocedural stroke during transcatheter aortic valve implantation is a rare but devastating complication. The calcified aortic valve is the most likely source of the emboli in a periprocedural stroke. The total load and distribution of calcium in the leaflets, aortic root, and left ventricular outflow tract varies from patient to patient. Consequently, there could be patterns of calcification that are associated with a higher risk of stroke. This study aimed to explore whether the pattern of calcification in the left ventricular outflow tract, annulus, aortic valve, and ascending aorta can be used to predict a periprocedural stroke. Methods: Among the 3282 consecutive patients who received a transcatheter aortic valve... (More)
Background: Periprocedural stroke during transcatheter aortic valve implantation is a rare but devastating complication. The calcified aortic valve is the most likely source of the emboli in a periprocedural stroke. The total load and distribution of calcium in the leaflets, aortic root, and left ventricular outflow tract varies from patient to patient. Consequently, there could be patterns of calcification that are associated with a higher risk of stroke. This study aimed to explore whether the pattern of calcification in the left ventricular outflow tract, annulus, aortic valve, and ascending aorta can be used to predict a periprocedural stroke. Methods: Among the 3282 consecutive patients who received a transcatheter aortic valve implantation in the native valve in Sweden from 2014 to 2018, we identified 52 who had a periprocedural stroke. From the same cohort, a control group of 52 patients was constructed by propensity score matching. Both groups had one missing cardiac computed tomography, and 51 stroke and 51 control patients were blindly reviewed by an experienced radiologist. Results: The groups were well balanced in terms of demographics and procedural data. Of the 39 metrics created to describe calcium pattern, only one differed between the groups. The length of calcium protruding above the annulus was 10.6 mm (interquartile range 7-13.6) for patients without stroke and 8 mm (interquartile range 3-10) for stroke patients. Conclusions: This study could not find any pattern of calcification that predisposes for a periprocedural stroke.
(Less)
- author
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cerebral protection device, Outcome, TAVR, Transcatheter aortic valve replacement
- in
- Structural Heart
- volume
- 6
- issue
- 4
- article number
- 100070
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:37288334
- scopus:85135502967
- ISSN
- 2474-8706
- DOI
- 10.1016/j.shj.2022.100070
- project
- Outcome after transcatheter valve interventions
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2022 The Author(s)
- id
- 9ed655b3-c0d7-44c1-9f87-a64836770614
- date added to LUP
- 2022-08-14 22:35:08
- date last changed
- 2024-04-04 10:48:39
@article{9ed655b3-c0d7-44c1-9f87-a64836770614,
abstract = {{<p>Background: Periprocedural stroke during transcatheter aortic valve implantation is a rare but devastating complication. The calcified aortic valve is the most likely source of the emboli in a periprocedural stroke. The total load and distribution of calcium in the leaflets, aortic root, and left ventricular outflow tract varies from patient to patient. Consequently, there could be patterns of calcification that are associated with a higher risk of stroke. This study aimed to explore whether the pattern of calcification in the left ventricular outflow tract, annulus, aortic valve, and ascending aorta can be used to predict a periprocedural stroke. Methods: Among the 3282 consecutive patients who received a transcatheter aortic valve implantation in the native valve in Sweden from 2014 to 2018, we identified 52 who had a periprocedural stroke. From the same cohort, a control group of 52 patients was constructed by propensity score matching. Both groups had one missing cardiac computed tomography, and 51 stroke and 51 control patients were blindly reviewed by an experienced radiologist. Results: The groups were well balanced in terms of demographics and procedural data. Of the 39 metrics created to describe calcium pattern, only one differed between the groups. The length of calcium protruding above the annulus was 10.6 mm (interquartile range 7-13.6) for patients without stroke and 8 mm (interquartile range 3-10) for stroke patients. Conclusions: This study could not find any pattern of calcification that predisposes for a periprocedural stroke.</p>}},
author = {{Bjursten, Henrik and Koul, Sasha and Duvernoy, Olov and Fagman, Erika and Samano, Ninos and Nilsson, Johan and Nielsen, Niels Erik and Rück, Andreas and Johansson, Jan and James, Stefan and Settergren, Magnus and Götberg, Matthias and Pistea, Adrian}},
issn = {{2474-8706}},
keywords = {{Cerebral protection device; Outcome; TAVR; Transcatheter aortic valve replacement}},
language = {{eng}},
number = {{4}},
publisher = {{Taylor & Francis}},
series = {{Structural Heart}},
title = {{Calcium Load in the Aortic Valve, Aortic Root, and Left Ventricular Outflow Tract and the Risk for a Periprocedural Stroke}},
url = {{http://dx.doi.org/10.1016/j.shj.2022.100070}},
doi = {{10.1016/j.shj.2022.100070}},
volume = {{6}},
year = {{2022}},
}