Calcium score association with paravalvular leakage in patients who underwent TAVR, the Mexican values.

Jhonathan Uribe-Gonzalez, Daniela L Leocachin-Parra, Jorge Torres-Rosales, Jhonathan Zamudio-Lopez, Efrain Arizmendi-Uribe, Guillermo Saturno-Chiu, Gela Pimentel-Morales, Oscar Millan-Iturbe, Joel Estrada-Gallegos
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Abstract

Objective: The objective is to determinate the association between the degree of aortic valve calcification and the presence of paravalvular leakage (PVL) in Mexican patients who underwent transcatheter aortic valve replacement (TAVR).

Methods: We conducted a retrospective, analytic, cohort. Pooled data were retrospectively analyzed from the patient's files from January 2014 to July 2022. With a median follow-up of 6 months.

Results: We included 83 patients. 31 (37.3%) developed residual PVL. Several factors as male gender (men 58.1% versus women 41.9% p = 0.01), higher gradients previous TAVR (mean 57 mmHg in the group with versus mean 53 mmHg in the group without PVL, p = 0.01), bigger annulus diameters and perimeters as well as reduce left ventricular ejection fraction and a degree of aortic regurgitation previous TAVR were present more frequently in the group of residual PVL. Aortic valve calcification was the only predictor after the bivariate and multivariate analysis that showed an association with the presence of PVL after TAVR. The calculated cut-off value of calcium score was 2970 Agatston units, with a sensitivity of 70% and a specificity of 60% as a predictor for PVL.

Conclusions: The results are consistent with the previous data and there are no greater differences in the Mexican population. The severity of the aortic valve calcification is an independent predictor of PVL in patients who underwent TAVR.

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目的目的是确定接受经导管主动脉瓣置换术(TAVR)的墨西哥患者主动脉瓣钙化程度与主动脉瓣旁漏(PVL)之间的关系:我们进行了一项回顾性队列分析。我们对2014年1月至2022年7月的患者档案中的数据进行了回顾性分析。中位随访时间为 6 个月:我们纳入了 83 名患者。31人(37.3%)出现残余PVL。在残余PVL组中,男性(男性占58.1%,女性占41.9%,P = 0.01)、曾行TAVR的梯度更高(有PVL组平均为57 mmHg,无PVL组平均为53 mmHg,P = 0.01)、瓣环直径和周径更大、左室射血分数降低以及曾行TAVR的主动脉瓣有一定程度的反流等因素更为常见。主动脉瓣钙化是双变量和多变量分析后唯一显示与 TAVR 后 PVL 存在相关性的预测因子。计算得出的钙化评分临界值为2970阿加斯顿单位,预测PVL的敏感性为70%,特异性为60%:结果与之前的数据一致,在墨西哥人群中没有更大的差异。主动脉瓣钙化的严重程度是预测接受 TAVR 患者 PVL 的独立指标。
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