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Article

High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry

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Department of Cardiology, University Hospital of Brest, 29200 Brest, France
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Cardiology Service, Rouen-Charles-Nicolle University Hospital Center, National Institute of Health and Medical Research U644, 76000 Rouen, France
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Division of Cardiology, Soroka Medical Center, Beer-Sheva P.O. Box 151, Israel
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Department of Cardiology and Surgery, Institut Cardiovasculaire Paris Sud, 91300 Massy, France
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Clinique Pasteur, 31000 Toulouse, France
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Cardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, 75651 Paris, France
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Cardiology and Vascular Diseases Service, Pontchaillou University Hospital Center, 35000 Rennes, France
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Faculty of Medecine Laënnec, University Claude Bernard Lyon, 69000 Lyon, France
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Cardiologic Hospital, 3 bd du Pr, Leclercq, CEDEX, 59037 Lille, France
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Department of Cardiology, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, 94000 Creteil, France
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Department of Cardiology, La Timone University Hospital Center, Public Assistance Hospitals of Marseille, National Institute of Health and Medical Research UMR 1062, French National Institute for Agricultural Research UMR 1260, University of Aix-Marseille, 13000 Marseille, France
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Department of Cardiology, University Hospital Department Fire and Paris-Diderot University, Public Assistance Hospitals of Paris, Bichat Hospital, 75013 Paris, France
*
Author to whom correspondence should be addressed.
Academic Editor: Francesco Formica
J. Clin. Med. 2021, 10(15), 3221; https://doi.org/10.3390/jcm10153221
Received: 29 June 2021 / Revised: 16 July 2021 / Accepted: 20 July 2021 / Published: 22 July 2021
(This article belongs to the Special Issue New Frontiers in Structural Heart Disease)
Mean Gradient (MG) elevation can be detected immediately after transcatheter aortic valve implantation (TAVI) or secondarily during follow-up. Comparisons and interactions between these two parameters and their impact on outcomes have not previously been investigated. This study aimed to identify incidence, influence on prognosis, and parameters associated with immediate high post-procedural mean transvalvular gradient (PPMG) and delayed mean gradient increase (6 to 12 months after TAVI, DMGI) in the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry. The registry includes all consecutive symptomatic patients with severe aortic stenosis who have undergone TAVI. Three groups were analyzed: (1) PPMG < 20 mmHg without DMGI > 10 mmHg (control); (2) PPMG < 20 mmHg with DMGI > 10 mmHg (Group 1); and (3) PPMG ≥ 20 mmHg (Group 2). From January 2010 to January 2012, 4201 consecutive patients were prospectively enrolled in the registry. Controls comprised 2078 patients. In Group 1(n = 131 patients), DMGI exceeded 10 mmHg in 5.6%, and was not associated with greater 4-years mortality than in controls (32.6% vs. 40.1%, p = 0.27). In Group 2 (n = 144 patients), PPMG was at least 20 mmHg in 6.1% and was associated with higher 4-year mortality (48.7% versus 40.1%, p = 0.005). A total of two-thirds of the patients with PPMG ≥ 20 mmHg had MG < 20 mmHg at 1 year, with mortality similar to the controls (39.2% vs. 40.1%, p = 0.73). Patients with PPMG > 20 mmHg 1 year post-TAVI had higher 4-years mortality than the general population of the registry, unlike patients with MG normalization. View Full-Text
Keywords: mean gradient; structural valve degeneration; TAVI; post-procedural mean gradient mean gradient; structural valve degeneration; TAVI; post-procedural mean gradient
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MDPI and ACS Style

Didier, R.; Benic, C.; Nasr, B.; Le Ven, F.; Hannachi, S.; Eltchaninoff, H.; Koifman, E.; Donzeau-Gouge, P.; Fajadet, J.; Leprince, P.; Leguerrier, A.; Lièvre, M.; Prat, A.; Teiger, E.; Lefevre, T.; Cuisset, T.; Le Breton, H.; Auffret, V.; Iung, B.; Gilard, M. High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry. J. Clin. Med. 2021, 10, 3221. https://doi.org/10.3390/jcm10153221

AMA Style

Didier R, Benic C, Nasr B, Le Ven F, Hannachi S, Eltchaninoff H, Koifman E, Donzeau-Gouge P, Fajadet J, Leprince P, Leguerrier A, Lièvre M, Prat A, Teiger E, Lefevre T, Cuisset T, Le Breton H, Auffret V, Iung B, Gilard M. High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry. Journal of Clinical Medicine. 2021; 10(15):3221. https://doi.org/10.3390/jcm10153221

Chicago/Turabian Style

Didier, Romain, Clément Benic, Bahaa Nasr, Florent Le Ven, Sinda Hannachi, Hélène Eltchaninoff, Edward Koifman, Patrick Donzeau-Gouge, Jean Fajadet, Pascal Leprince, Alain Leguerrier, Michel Lièvre, Alain Prat, Emmanuel Teiger, Thierry Lefevre, Thomas Cuisset, Herve Le Breton, Vincent Auffret, Bernard Iung, and Martine Gilard. 2021. "High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry" Journal of Clinical Medicine 10, no. 15: 3221. https://doi.org/10.3390/jcm10153221

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