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Article

Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities

1
Cardiology Department, Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
2
Institut Pascal, SIGMA Clermont, Centre National de la Recherche Scientifique, Université Clermont Auvergne, Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
3
Biostatistics Unit (Clinical Research and Innovation Direction), Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
*
Author to whom correspondence should be addressed.
Diagnostics 2023, 13(3), 427; https://doi.org/10.3390/diagnostics13030427
Received: 15 December 2022 / Revised: 16 January 2023 / Accepted: 20 January 2023 / Published: 24 January 2023
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Cardiac Arrhythmias)

Abstract

The impact that post-dilatation has on the risk of experiencing conduction disorders after post-transcatheter aortic valve replacement with self-expanding valves (SE-TAVR) is unclear. We compared the rate of developing an atrioventricular (AV) high-grade conduction disorder and permanent pacemaker implantation (PPI) in post-TAVR patients undergoing post-dilatation. We enrolled patients with severe symptomatic calcified aortic stenosis (CAS) who were undergoing SE-TAVR between 1 January 2016, and 19 April 2019 at a single French center. Of the 532 patients treated with SE-TAVR, 417 subjects (78.4%) received Corevalve Evolute R and 115 subjects (21.6%) received the latest-generation Corevalve Evolute Pro valve. In total, 104/532 patients (19.5%; 21.6% with Evolute R vs. 12.2% with Evolute Pro, p = 0.024) required post-dilatation. Evolut R was associated with an increased risk of post-dilatation (odds ratio 2.1 (1.01–4.33, p = 0.046)). We did not observe any post-dilatation increases in AV or in intra- and interventricular conduction disorders. In total, 26.1% of participants needed PPI within the first 30 post-procedure days (p = 0.449). Post-dilatation was not associated with a higher PPI risk (subdistribution hazard ratio 1.033 (0.726–1.471); p = 0.857). No significant differences existed between the groups in terms of one-year mortality (10.3%; p = 0.507). Post-dilatation in SE-TAVR did not increase the rate of electrical conduction disorders and PPI in the early implantation phase. The latest generation of SE-TAVR valves was associated with less need for post-dilatation.
Keywords: post-dilatation; conductive disorders; TAVR; PPM post-dilatation; conductive disorders; TAVR; PPM

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MDPI and ACS Style

Massoullié, G.; Combaret, N.; Souteyrand, G.; Salazard, J.P.; Pereira, B.; Jean, F.; Motreff, P.; Taghli-Lamallem, O.; Clerfond, G.; Eschalier, R. Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities. Diagnostics 2023, 13, 427. https://doi.org/10.3390/diagnostics13030427

AMA Style

Massoullié G, Combaret N, Souteyrand G, Salazard JP, Pereira B, Jean F, Motreff P, Taghli-Lamallem O, Clerfond G, Eschalier R. Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities. Diagnostics. 2023; 13(3):427. https://doi.org/10.3390/diagnostics13030427

Chicago/Turabian Style

Massoullié, Grégoire, Nicolas Combaret, Géraud Souteyrand, Jean Pascal Salazard, Bruno Pereira, Frédéric Jean, Pascal Motreff, Ouarda Taghli-Lamallem, Guillaume Clerfond, and Romain Eschalier. 2023. "Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities" Diagnostics 13, no. 3: 427. https://doi.org/10.3390/diagnostics13030427

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