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You are here: Contents > 2016 > Volume 25 Number 3 May 2016 > AORTIC VALVE DISEASE > Predictors of High Post-Procedural Gradients after Catheter-Based Aortic Valve Implantation Using Direct Flow Medical Bioprostheses

Predictors of High Post-Procedural Gradients after Catheter-Based Aortic Valve Implantation Using Direct Flow Medical Bioprostheses

Frauke S. Czepluch1, Alexander Schwarz2, Tobias Tichelbäcker1, Joachim Lotz2, Gerd Hasenfuss1, Wolfgang Schillinger1, Claudius Jacobshagen1,3

1Department of Cardiology and Pulmonary Medicine, University Medical Center Göttingen, Göttingen, Germany
2Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
3Electronic correspondence: jacobshagen@med.uni-goettingen.de

Background and aim of the study: The Direct Flow Medical (DFM) valve is a new non-metallic and repositionable bioprosthesis used for transcatheter aortic valve implantation (TAVI). The study aim was to investigate procedural and post-implant valve data in patients receiving differently sized DFM bioprostheses.

Methods: Procedural, echocardiographic and computed tomography findings of 28 patients receiving either a 25, 27 or 29 mm DFM bioprosthesis were analyzed.

Results: Implantation of a 29 mm bioprosthesis was associated with longer procedure (p <0.05) and radiation (p <0.05) times, and a higher dose-area product (p <0.01) compared to the 25 mm valve. A high mean post-interventional aortic gradient indicating a suboptimal

result was found in 44% patients receiving a 29 mm bioprosthesis, whereas none of the patients with a 25 or 27 mm valve had a high gradient (p <0.05). Aortic valve calcification was greatest in the 29 mm group and correlated with a higher dose-area product (p <0.01).

Conclusion: DFM bioprosthesis size significantly influences the TAVI procedure and post-implant valve function. Valve calcification and use of the 29 mm DFM bioprosthesis per se possibly predict a more complicated procedure. Therefore, annulus size and valve calcification severity should be taken into consideration when deciding which bioprosthesis type might be best suited for individual patients.

The Journal of Heart Valve Disease 2016;25:281-288


Predictors of High Post-Procedural Gradients after Catheter-Based Aortic Valve Implantation Using Direct Flow Medical Bioprostheses

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