Position of Edwards SAPIEN transcatheter valve in the aortic root in relation with the coronary ostia. Issue 3 (12th November 2014)

• Record Type: Journal Article
• Authors: Katsanos, Spyridon; Debonnaire, Philippe; van der Kley, Frank; van Rosendael, Philippe; Joyce, Emer; de Graaf, Michiel A.; Schalij, Martin J.; Scholte, Arthur J.H.A.; Bax, Jeroen J.; Ajmone Marsan, Nina; Delgado, Victoria
• Is Part Of: Catheterization and cardiovascular interventions. Volume 85:Issue 3(2015:Feb. 15)
• Page Start: 480
• Page End: 487
• Publication Date: 2014-11-12
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25718
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25718-sec-0001" sec-type="section"> <title>Objectives</title> <p>To determine the implications of stable coverage of the coronary ostia by the Edwards SAPIEN valve frame in terms of myocardial ischemia and subsequent percutaneous coronary intervention (PCI), following transcatheter aortic valve implantation (TAVI).</p> </sec> <sec id="ccd25718-sec-0002" sec-type="section"> <title>Background</title> <p>Edwards SAPIEN frame is frequently deployed relatively higher than recommended and may overlap the coronary ostia.</p> </sec> <sec id="ccd25718-sec-0003" sec-type="section"> <title>Methods</title> <p>A total of 142 patients (age 81 ± 7 years, male 49%) treated with Edwards SAPIEN valve and with multi‐detector row computed tomography at 1 month follow‐up were evaluated. The position of the frame in relation to the coronary ostia was assessed. Levels of troponin T were measured 12–24 hr after TAVI. PCI events at follow‐up were recorded.</p> </sec> <sec id="ccd25718-sec-0004" sec-type="section"> <title>Results</title> <p>The left coronary ostium was fully covered in three (2.1%) patients and the right coronary ostium in 11 (7.7%). There were no differences in troponin T levels between patients with fully covered ostia versus patients with partly or non‐covered ostia (0.24 (0.13–0.50) μg/L versus 0.35 (0.15–0.55) μg/L, respectively; <italic>P</italic> = 0.377). At 30 ± 15 months follow up, 10 (7%) patients underwent successful PCI. Rate of subsequent PCI was similar between patients with any covered ostium and patients with non‐covered ostia [4 (7.8%) vs. 6 (6.5%), <italic>P</italic> = 0.780, respectively].</p> </sec> <sec id="ccd25718-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Full overlap of the coronary ostia by Edwards SAPIEN frame is infrequent and in most cases does not limit subsequent PCI. <related-article related-article-type="source" xlink:type="simple" xmlns:xlink="http://www.w3.org/1999/xlink">© 2014 Wiley Periodicals, Inc.</related-article></p> </sec> </abstract>