Biomaterial Database

Coronary access after transcatheter aortic valve replacement in bicuspid versus tricuspid aortic stenosis. 2022

Fei Chen, and Kaiyu Jia, and Yijian Li, and Tianyuan Xiong, and Xi Wang, and Zhongkai Zhu, and Yuanweixiang Ou, and Xi Li, and Xin Wei, and Zhengang Zhao, and Qiao Li, and Sen He, and Jiafu Wei, and Yong Peng, and Yuan Feng, and Mao Chen

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.

BACKGROUND It is unknown whether there are differences in coronary access after transcatheter aortic valve replacement (TAVR) between bicuspid and tricuspid anatomy. OBJECTIVE Our aim was to investigate coronary access after TAVR using a self-expanding transcatheter heart valve (THV) in bicuspid versus tricuspid aortic valves (BAV vs TAV), based on CT simulation. METHODS A total of 86 type 0 BAV, 70 type 1 BAV, and 132 TAV patients were included. If the coronary ostium faced the sealed parts of the THV or the tilted-up native leaflet (NL), this was defined as THV- or NL-related challenging coronary access, respectively. If coaxial engagement was not allowed due to interference from the unwrapped frame, THV-related complex coronary access was defined. RESULTS The incidence of THV-related challenging coronary access was 21.2% for the left coronary artery (LCA) and 17.7% for the right coronary artery (RCA), and type 0 BAV patients encountered fewer THV-related challenging LCA access than their TAV counterparts (OR 0.42, 95% CI: 0.20-0.89). NL-related challenging coronary access was observed in 3.1% for LCA and 1.4% for RCA, and THV-related complex coronary access was identified in 5.9% for LCA and 17.0% for RCA; however, no significant differences were found among groups. The proportion of optimal fluoroscopic viewing angles suitable for guiding LCA engagement was similar among groups (64.0% vs 70.0% vs 62.1%), but those suitable for guiding RCA engagement were significantly higher in the type 0 BAV group (31.4% vs 4.3% vs 9.1%). CONCLUSIONS Coronary access may be challenging or complex in a significant proportion of both BAV and TAV patients after TAVR. Type 0 BAV anatomy may be more favourable for post-TAVR coronary access.

UI	MeSH Term	Description	Entries
D006349	Heart Valve Diseases	Pathological conditions involving any of the various HEART VALVES and the associated structures (PAPILLARY MUSCLES and CHORDAE TENDINEAE).	Heart Valvular Disease,Valvular Heart Diseases,Disease, Heart Valvular,Heart Disease, Valvular,Heart Valve Disease,Heart Valvular Diseases,Valve Disease, Heart,Valvular Disease, Heart,Valvular Heart Disease
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000082882	Bicuspid Aortic Valve Disease	Congenital heart valve defects where the AORTIC VALVE has two instead of normal three cusps. It is often associated with AORTIC REGURGITATION and AORTIC INSUFFICIENCY.	Bicuspid Aortic Valve, Single Raphe,Bicuspid Aortic Valve, Two-Raphe,Double Raphe Bicuspid Aortic Valve,Purely Bicuspid Aortic Valve,Single Raphe Bicuspid Aortic Valve,Two Raphe Bicuspid Aortic Valve,Two-Raphe Bicuspid Aortic Valve,Aortic Valve Disease 1,Aortic Valve, Bicuspid,Bicuspid Aortic Valve,Bicuspid Aortic Valve, Two Raphe,Bicuspid Aortic Valves,Valve, Bicuspid Aortic
D001021	Aortic Valve	The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.	Aortic Valves,Valve, Aortic,Valves, Aortic
D001024	Aortic Valve Stenosis	A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.	Aortic Stenosis,Aortic Valve Stenoses,Stenoses, Aortic,Stenoses, Aortic Valve,Stenosis, Aortic,Stenosis, Aortic Valve,Valve Stenoses, Aortic,Valve Stenosis, Aortic
D016896	Treatment Outcome	Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.	Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D065467	Transcatheter Aortic Valve Replacement	Surgical treatment for severe AORTIC VALVE STENOSIS. Transcatheter aortic valve replacement (TAVR) is used as an alternative option in patients who are deemed at high risk or inoperable for traditional open-heart surgery.	Transcatheter Aortic Valve Implantation