Document Detail


Hemodynamic results and changes in myocardial function after transcatheter aortic valve implantation.
MedLine Citation:
PMID:  20435207     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This prospective study was designed to evaluate the hemodynamic results of transcatheter aortic valve implantation (TAVI) with the CoreValve prosthesis (Medtronic, Minneapolis, Minnesota) and the effects on left ventricular function. METHODS: From June 2008 to June 2009, consecutive patients with severe symptomatic aortic valve stenosis (aortic valve area <1 cm(2)) and the indication for TAVI were included. Aortic valve prosthesis was inserted retrograde. Examinations of study patients were performed before, 30 days, and 6 months after TAVI and comprised measurement of B-type natriuretic peptide and echocardiography. Severe prosthesis-patient mismatch was defined as an indexed effective aortic valve area < or =0.65 cm(2)/m(2). RESULTS: In 39 patients, follow-up examinations were performed after TAVI. Severe prosthesis-patient mismatch seldom occurred (n = 1), but mild to moderate aortic valve regurgitation due to paravalvular leaks was common (n = 24, 62%). After 6 months, left ventricular mass index declined (158 +/- 46 vs 138 +/- 45 g/m(2), P = .001), and peak early diastolic mitral annular velocity (E') and peak systolic mitral annular velocity (S') increased (P = .004 and P < .001, respectively). B-type natriuretic peptide levels decreased (744 +/- 708 at baseline vs 367 +/- 273 at 30 days, P = .003, 279 +/- 186 pg/mL at 6 months, P = .001). Left ventricular diameters and ejection fraction remained unchanged. CONCLUSION: Despite the high incidence of paravalvular regurgitation after TAVI, hemodynamic results were favorable. Furthermore, TAVI had positive effects on left ventricular remodeling and improved neurohormonal activity, myocardial hypertrophy, and diastolic function.
Authors:
Michael Gotzmann; Michael Lindstaedt; Waldemar Bojara; Andreas M?gge; Alfried Germing
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  159     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-03     Completed Date:  2010-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  926-32     Citation Subset:  AIM; IM    
Copyright Information:
2010 Mosby, Inc. All rights reserved.
Affiliation:
BG-Kliniken Bergmannsheil, Medical Clinic II, Ruhr-University Bochum, Germany. michael_gotzmann@web.de <michael_gotzmann@web.de>
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve / surgery*
Aortic Valve Insufficiency / epidemiology
Aortic Valve Stenosis / surgery*
Cardiac Volume
Echocardiography, Doppler
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation*
Hemodynamics
Humans
Male
Natriuretic Peptide, Brain / analysis
Postoperative Complications / epidemiology
Prospective Studies
Ventricular Dysfunction, Left / epidemiology
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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