Anatomic and procedural associations of transcatheter heart valve displacement following Evolut R implantation
Objectives This study aimed to predict the displacement of self‐expanding transcatheter heart valves (THV) during final deployment. Background Accurate device positioning during transcatheter aortic valve implantation (TAVI) is crucial for optimal results. Methods At our institution, 103 patients wh...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2019-02, Vol.93 (3), p.522-529 |
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| creator | Hachinohe, Daisuke Latib, Azeem Laricchia, Alessandra Demir, Ozan M. Agricola, Eustachio Romano, Vittorio Del Sole, Paolo Alberto Leone, Pier Pasquale Ancona, Marco B. Mangieri, Antonio Regazzoli, Damiano Giannini, Francesco Mitomo, Satoru Monaco, Fabrizio Buzzatti, Nicola Montorfano, Matteo Colombo, Antonio |
| description | Objectives
This study aimed to predict the displacement of self‐expanding transcatheter heart valves (THV) during final deployment.
Background
Accurate device positioning during transcatheter aortic valve implantation (TAVI) is crucial for optimal results.
Methods
At our institution, 103 patients who underwent transfemoral TAVI with Evolut R were retrospectively identified. Multiple linear regression models were created, and a predictor equation was built to quantify the factors that may affect THV behavior.
Results
Multiple linear regression analysis for THV displacement on the left coronary cusp (LCC) identified the angle between the THV and the ascending aorta (ATA), predilation, and less operator experience as independent predictors of upward displacement, whereas estimated glomerular filtration rate (eGFR) was inversely related with THV behavior (95% confidence interval: 0.219 to 0.340, 0.447 to 2.092, 0.165 to 1.757, and −0.053 to −0.011, respectively). Predictors of THV displacement on the noncoronary cusp side could not be identified using this model.
Conclusions
The ATA at the point of recapture, predilation, and less operator experience were independent predictors of upward displacement of THV on the LCC side. eGFR was an independent predictor of THV downward displacement on the LCC side. Of them, the ATA was the strongest predictor. Physicians may need to adjust this angle adequately before deployment to achieve the appropriate position. |
| doi_str_mv | 10.1002/ccd.27827 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2116850911</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2116850911</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4197-6a03c275de9b857a41e5a03ddc68b39c14f2a3a15ddceaeae77e7b32272d06d83</originalsourceid><addsrcrecordid>eNp1kU1rGzEQhkVJaD7aQ_9AEeSSHBxL2tVq9xicNC0EAqGF3paxNJsoaCVX0tr431eJnRwKRQeJ0cPDzLyEfOHskjMm5lqbS6FaoT6QYy6FmCnR_D7Yv3lXN0fkJKVnxljXiO4jOaqYaBvJ5THxVx5yGK2m4A1dxaDRTBEchZSCtpBt8ImGgeYIPmnIT5gx0ieEmOka3BqpsWnlQOOIPtMhOBc21j_Sm3VwU6YP1I7l2-dX1SdyOIBL-Hl_n5Jf325-Lr7P7u5vfyyu7ma65p2aNcAqLZQ02C1bqaDmKEvJGN20y6rTvB4EVMBlqSCUoxSqZSWEEoY1pq1OyfnOWyb6M2HK_WiTRlcawTClXnDetJJ1nBf07B_0OUzRl-4K1XIlasFloS52lI4hpYhDv4p2hLjtOetfQuhLCP1rCIX9ujdOyxHNO_m29QLMd8DGOtz-39QvFtc75V9FqZKH</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2181724215</pqid></control><display><type>article</type><title>Anatomic and procedural associations of transcatheter heart valve displacement following Evolut R implantation</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Hachinohe, Daisuke ; Latib, Azeem ; Laricchia, Alessandra ; Demir, Ozan M. ; Agricola, Eustachio ; Romano, Vittorio ; Del Sole, Paolo Alberto ; Leone, Pier Pasquale ; Ancona, Marco B. ; Mangieri, Antonio ; Regazzoli, Damiano ; Giannini, Francesco ; Mitomo, Satoru ; Monaco, Fabrizio ; Buzzatti, Nicola ; Montorfano, Matteo ; Colombo, Antonio</creator><creatorcontrib>Hachinohe, Daisuke ; Latib, Azeem ; Laricchia, Alessandra ; Demir, Ozan M. ; Agricola, Eustachio ; Romano, Vittorio ; Del Sole, Paolo Alberto ; Leone, Pier Pasquale ; Ancona, Marco B. ; Mangieri, Antonio ; Regazzoli, Damiano ; Giannini, Francesco ; Mitomo, Satoru ; Monaco, Fabrizio ; Buzzatti, Nicola ; Montorfano, Matteo ; Colombo, Antonio</creatorcontrib><description>Objectives
This study aimed to predict the displacement of self‐expanding transcatheter heart valves (THV) during final deployment.
Background
Accurate device positioning during transcatheter aortic valve implantation (TAVI) is crucial for optimal results.
Methods
At our institution, 103 patients who underwent transfemoral TAVI with Evolut R were retrospectively identified. Multiple linear regression models were created, and a predictor equation was built to quantify the factors that may affect THV behavior.
Results
Multiple linear regression analysis for THV displacement on the left coronary cusp (LCC) identified the angle between the THV and the ascending aorta (ATA), predilation, and less operator experience as independent predictors of upward displacement, whereas estimated glomerular filtration rate (eGFR) was inversely related with THV behavior (95% confidence interval: 0.219 to 0.340, 0.447 to 2.092, 0.165 to 1.757, and −0.053 to −0.011, respectively). Predictors of THV displacement on the noncoronary cusp side could not be identified using this model.
Conclusions
The ATA at the point of recapture, predilation, and less operator experience were independent predictors of upward displacement of THV on the LCC side. eGFR was an independent predictor of THV downward displacement on the LCC side. Of them, the ATA was the strongest predictor. Physicians may need to adjust this angle adequately before deployment to achieve the appropriate position.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.27827</identifier><identifier>PMID: 30286515</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Aged ; Aged, 80 and over ; Aorta ; aortic stenosis ; Aortic valve ; Aortic Valve - diagnostic imaging ; Aortic Valve - physiopathology ; Aortic Valve - surgery ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - physiopathology ; Aortic Valve Stenosis - surgery ; Bioprosthesis ; displacement ; Epidermal growth factor receptors ; Female ; Glomerular filtration rate ; Heart Valve Prosthesis ; Humans ; Implantation ; Male ; Medical personnel ; Postoperative Complications - etiology ; Postoperative Complications - physiopathology ; Prosthesis Design ; Regression analysis ; Retrospective Studies ; Risk Factors ; self‐expanding ; Severity of Illness Index ; TAVI ; TAVR ; Time Factors ; transcatheter aortic valve implantation ; Transcatheter Aortic Valve Replacement - adverse effects ; Transcatheter Aortic Valve Replacement - instrumentation ; Treatment Outcome</subject><ispartof>Catheterization and cardiovascular interventions, 2019-02, Vol.93 (3), p.522-529</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4197-6a03c275de9b857a41e5a03ddc68b39c14f2a3a15ddceaeae77e7b32272d06d83</citedby><cites>FETCH-LOGICAL-c4197-6a03c275de9b857a41e5a03ddc68b39c14f2a3a15ddceaeae77e7b32272d06d83</cites><orcidid>0000-0001-8972-4352 ; 0000-0003-4828-1836 ; 0000-0001-8909-5277 ; 0000-0002-0517-1410</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.27827$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.27827$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45552,45553</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30286515$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hachinohe, Daisuke</creatorcontrib><creatorcontrib>Latib, Azeem</creatorcontrib><creatorcontrib>Laricchia, Alessandra</creatorcontrib><creatorcontrib>Demir, Ozan M.</creatorcontrib><creatorcontrib>Agricola, Eustachio</creatorcontrib><creatorcontrib>Romano, Vittorio</creatorcontrib><creatorcontrib>Del Sole, Paolo Alberto</creatorcontrib><creatorcontrib>Leone, Pier Pasquale</creatorcontrib><creatorcontrib>Ancona, Marco B.</creatorcontrib><creatorcontrib>Mangieri, Antonio</creatorcontrib><creatorcontrib>Regazzoli, Damiano</creatorcontrib><creatorcontrib>Giannini, Francesco</creatorcontrib><creatorcontrib>Mitomo, Satoru</creatorcontrib><creatorcontrib>Monaco, Fabrizio</creatorcontrib><creatorcontrib>Buzzatti, Nicola</creatorcontrib><creatorcontrib>Montorfano, Matteo</creatorcontrib><creatorcontrib>Colombo, Antonio</creatorcontrib><title>Anatomic and procedural associations of transcatheter heart valve displacement following Evolut R implantation</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Objectives
This study aimed to predict the displacement of self‐expanding transcatheter heart valves (THV) during final deployment.
Background
Accurate device positioning during transcatheter aortic valve implantation (TAVI) is crucial for optimal results.
Methods
At our institution, 103 patients who underwent transfemoral TAVI with Evolut R were retrospectively identified. Multiple linear regression models were created, and a predictor equation was built to quantify the factors that may affect THV behavior.
Results
Multiple linear regression analysis for THV displacement on the left coronary cusp (LCC) identified the angle between the THV and the ascending aorta (ATA), predilation, and less operator experience as independent predictors of upward displacement, whereas estimated glomerular filtration rate (eGFR) was inversely related with THV behavior (95% confidence interval: 0.219 to 0.340, 0.447 to 2.092, 0.165 to 1.757, and −0.053 to −0.011, respectively). Predictors of THV displacement on the noncoronary cusp side could not be identified using this model.
Conclusions
The ATA at the point of recapture, predilation, and less operator experience were independent predictors of upward displacement of THV on the LCC side. eGFR was an independent predictor of THV downward displacement on the LCC side. Of them, the ATA was the strongest predictor. Physicians may need to adjust this angle adequately before deployment to achieve the appropriate position.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aorta</subject><subject>aortic stenosis</subject><subject>Aortic valve</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - physiopathology</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - physiopathology</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Bioprosthesis</subject><subject>displacement</subject><subject>Epidermal growth factor receptors</subject><subject>Female</subject><subject>Glomerular filtration rate</subject><subject>Heart Valve Prosthesis</subject><subject>Humans</subject><subject>Implantation</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - physiopathology</subject><subject>Prosthesis Design</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>self‐expanding</subject><subject>Severity of Illness Index</subject><subject>TAVI</subject><subject>TAVR</subject><subject>Time Factors</subject><subject>transcatheter aortic valve implantation</subject><subject>Transcatheter Aortic Valve Replacement - adverse effects</subject><subject>Transcatheter Aortic Valve Replacement - instrumentation</subject><subject>Treatment Outcome</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1rGzEQhkVJaD7aQ_9AEeSSHBxL2tVq9xicNC0EAqGF3paxNJsoaCVX0tr431eJnRwKRQeJ0cPDzLyEfOHskjMm5lqbS6FaoT6QYy6FmCnR_D7Yv3lXN0fkJKVnxljXiO4jOaqYaBvJ5THxVx5yGK2m4A1dxaDRTBEchZSCtpBt8ImGgeYIPmnIT5gx0ieEmOka3BqpsWnlQOOIPtMhOBc21j_Sm3VwU6YP1I7l2-dX1SdyOIBL-Hl_n5Jf325-Lr7P7u5vfyyu7ma65p2aNcAqLZQ02C1bqaDmKEvJGN20y6rTvB4EVMBlqSCUoxSqZSWEEoY1pq1OyfnOWyb6M2HK_WiTRlcawTClXnDetJJ1nBf07B_0OUzRl-4K1XIlasFloS52lI4hpYhDv4p2hLjtOetfQuhLCP1rCIX9ujdOyxHNO_m29QLMd8DGOtz-39QvFtc75V9FqZKH</recordid><startdate>20190215</startdate><enddate>20190215</enddate><creator>Hachinohe, Daisuke</creator><creator>Latib, Azeem</creator><creator>Laricchia, Alessandra</creator><creator>Demir, Ozan M.</creator><creator>Agricola, Eustachio</creator><creator>Romano, Vittorio</creator><creator>Del Sole, Paolo Alberto</creator><creator>Leone, Pier Pasquale</creator><creator>Ancona, Marco B.</creator><creator>Mangieri, Antonio</creator><creator>Regazzoli, Damiano</creator><creator>Giannini, Francesco</creator><creator>Mitomo, Satoru</creator><creator>Monaco, Fabrizio</creator><creator>Buzzatti, Nicola</creator><creator>Montorfano, Matteo</creator><creator>Colombo, Antonio</creator><general>John Wiley & Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8972-4352</orcidid><orcidid>https://orcid.org/0000-0003-4828-1836</orcidid><orcidid>https://orcid.org/0000-0001-8909-5277</orcidid><orcidid>https://orcid.org/0000-0002-0517-1410</orcidid></search><sort><creationdate>20190215</creationdate><title>Anatomic and procedural associations of transcatheter heart valve displacement following Evolut R implantation</title><author>Hachinohe, Daisuke ; Latib, Azeem ; Laricchia, Alessandra ; Demir, Ozan M. ; Agricola, Eustachio ; Romano, Vittorio ; Del Sole, Paolo Alberto ; Leone, Pier Pasquale ; Ancona, Marco B. ; Mangieri, Antonio ; Regazzoli, Damiano ; Giannini, Francesco ; Mitomo, Satoru ; Monaco, Fabrizio ; Buzzatti, Nicola ; Montorfano, Matteo ; Colombo, Antonio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4197-6a03c275de9b857a41e5a03ddc68b39c14f2a3a15ddceaeae77e7b32272d06d83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aorta</topic><topic>aortic stenosis</topic><topic>Aortic valve</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - physiopathology</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - physiopathology</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Bioprosthesis</topic><topic>displacement</topic><topic>Epidermal growth factor receptors</topic><topic>Female</topic><topic>Glomerular filtration rate</topic><topic>Heart Valve Prosthesis</topic><topic>Humans</topic><topic>Implantation</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - physiopathology</topic><topic>Prosthesis Design</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>self‐expanding</topic><topic>Severity of Illness Index</topic><topic>TAVI</topic><topic>TAVR</topic><topic>Time Factors</topic><topic>transcatheter aortic valve implantation</topic><topic>Transcatheter Aortic Valve Replacement - adverse effects</topic><topic>Transcatheter Aortic Valve Replacement - instrumentation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hachinohe, Daisuke</creatorcontrib><creatorcontrib>Latib, Azeem</creatorcontrib><creatorcontrib>Laricchia, Alessandra</creatorcontrib><creatorcontrib>Demir, Ozan M.</creatorcontrib><creatorcontrib>Agricola, Eustachio</creatorcontrib><creatorcontrib>Romano, Vittorio</creatorcontrib><creatorcontrib>Del Sole, Paolo Alberto</creatorcontrib><creatorcontrib>Leone, Pier Pasquale</creatorcontrib><creatorcontrib>Ancona, Marco B.</creatorcontrib><creatorcontrib>Mangieri, Antonio</creatorcontrib><creatorcontrib>Regazzoli, Damiano</creatorcontrib><creatorcontrib>Giannini, Francesco</creatorcontrib><creatorcontrib>Mitomo, Satoru</creatorcontrib><creatorcontrib>Monaco, Fabrizio</creatorcontrib><creatorcontrib>Buzzatti, Nicola</creatorcontrib><creatorcontrib>Montorfano, Matteo</creatorcontrib><creatorcontrib>Colombo, Antonio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hachinohe, Daisuke</au><au>Latib, Azeem</au><au>Laricchia, Alessandra</au><au>Demir, Ozan M.</au><au>Agricola, Eustachio</au><au>Romano, Vittorio</au><au>Del Sole, Paolo Alberto</au><au>Leone, Pier Pasquale</au><au>Ancona, Marco B.</au><au>Mangieri, Antonio</au><au>Regazzoli, Damiano</au><au>Giannini, Francesco</au><au>Mitomo, Satoru</au><au>Monaco, Fabrizio</au><au>Buzzatti, Nicola</au><au>Montorfano, Matteo</au><au>Colombo, Antonio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anatomic and procedural associations of transcatheter heart valve displacement following Evolut R implantation</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2019-02-15</date><risdate>2019</risdate><volume>93</volume><issue>3</issue><spage>522</spage><epage>529</epage><pages>522-529</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract>Objectives
This study aimed to predict the displacement of self‐expanding transcatheter heart valves (THV) during final deployment.
Background
Accurate device positioning during transcatheter aortic valve implantation (TAVI) is crucial for optimal results.
Methods
At our institution, 103 patients who underwent transfemoral TAVI with Evolut R were retrospectively identified. Multiple linear regression models were created, and a predictor equation was built to quantify the factors that may affect THV behavior.
Results
Multiple linear regression analysis for THV displacement on the left coronary cusp (LCC) identified the angle between the THV and the ascending aorta (ATA), predilation, and less operator experience as independent predictors of upward displacement, whereas estimated glomerular filtration rate (eGFR) was inversely related with THV behavior (95% confidence interval: 0.219 to 0.340, 0.447 to 2.092, 0.165 to 1.757, and −0.053 to −0.011, respectively). Predictors of THV displacement on the noncoronary cusp side could not be identified using this model.
Conclusions
The ATA at the point of recapture, predilation, and less operator experience were independent predictors of upward displacement of THV on the LCC side. eGFR was an independent predictor of THV downward displacement on the LCC side. Of them, the ATA was the strongest predictor. Physicians may need to adjust this angle adequately before deployment to achieve the appropriate position.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>30286515</pmid><doi>10.1002/ccd.27827</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8972-4352</orcidid><orcidid>https://orcid.org/0000-0003-4828-1836</orcidid><orcidid>https://orcid.org/0000-0001-8909-5277</orcidid><orcidid>https://orcid.org/0000-0002-0517-1410</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1522-1946 |
| ispartof | Catheterization and cardiovascular interventions, 2019-02, Vol.93 (3), p.522-529 |
| issn | 1522-1946 1522-726X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2116850911 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Aged, 80 and over Aorta aortic stenosis Aortic valve Aortic Valve - diagnostic imaging Aortic Valve - physiopathology Aortic Valve - surgery Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - physiopathology Aortic Valve Stenosis - surgery Bioprosthesis displacement Epidermal growth factor receptors Female Glomerular filtration rate Heart Valve Prosthesis Humans Implantation Male Medical personnel Postoperative Complications - etiology Postoperative Complications - physiopathology Prosthesis Design Regression analysis Retrospective Studies Risk Factors self‐expanding Severity of Illness Index TAVI TAVR Time Factors transcatheter aortic valve implantation Transcatheter Aortic Valve Replacement - adverse effects Transcatheter Aortic Valve Replacement - instrumentation Treatment Outcome |
| title | Anatomic and procedural associations of transcatheter heart valve displacement following Evolut R implantation |
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