ONE YEAR SURVIVAL POST TAVR IN PATIENTS WITH NORMAL-FLOW-LOW-GRADIENT VS. PARADOXICAL LOW-FLOW-LOW GRADIENT AORTIC VALVE STENOSIS

Mohamad Hemu; Caleb Chiang; Jaafar Alward; Konstantinos Voudris; Hussam Suradi

doi:10.1016/S0735-1097(21)02519-5

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ONE YEAR SURVIVAL POST TAVR IN PATIENTS WITH NORMAL-FLOW-LOW-GRADIENT VS. PARADOXICAL LOW-FLOW-LOW GRADIENT AORTIC VALVE STENOSIS

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ONE YEAR SURVIVAL POST TAVR IN PATIENTS WITH NORMAL-FLOW-LOW-GRADIENT VS. PARADOXICAL LOW-FLOW-LOW GRADIENT AORTIC VALVE STENOSIS

Mohamad Hemu, Caleb Chiang, Jaafar Alward, Konstantinos Voudris and Hussam Suradi

Journal of the American College of Cardiology, Vol.77(18 Supplement 1), pp.1160-1160

05/11/2021

DOI: 10.1016/S0735-1097(21)02519-5

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Abstract

Background The optimal treatment strategy of symptomatic severe aortic stenosis (SAS) in patients with normal-flow, low gradient SAS (NF-LG-SAS) is currently debatable. We sought to determine whether the prognosis of patients with NF-LG-SAS vs. Paradoxical low-flow-low gradient SAS (LF-LG-SAS) is fundamentally different post transcatheter aortic valve replacement (TAVR) Methods A total of 83 patients (42% female, 85±9.5) who underwent TAVR were retrospectively analyzed. NF-LG-SAS was defined by aortic valve area (AVA) < 1cm2, mean gradient (MG) < 40 mmHg, and indexed stroke volume (SVi) >35 mL/m2. LF-LG-SAS was defined by AVA < 1cm2, MG < 40 mmHg, and SVi < 35 mL/m2. Primary outcome included 1-year all-cause mortality post-TAVR. Heart failure exacerbation, acute coronary syndrome, new onset atrial fibrillation, stroke, and permanent pacemaker placement were included as secondary outcomes Results A total of 29 patients with NF-LG-SAS and 54 with LF-LG-SAS were identified. In multivariate analyses adjusting for covariates of prognostic importance, there was a non-statistically significant trend towards improved survival in patients with NF-LG-SAS vs. LF-LG-SAS (HR 0.28, [95% CI, 0.05-1.38]; P=0.12) (Figure). A separate analysis showed no significant difference between groups with regards to secondary outcomes Conclusion To our knowledge, this is the first study comparing survival after TAVR in patients with paradoxical LF-LG-SAS and NF-LG-SAS.

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Title: Subtitle: ONE YEAR SURVIVAL POST TAVR IN PATIENTS WITH NORMAL-FLOW-LOW-GRADIENT VS. PARADOXICAL LOW-FLOW-LOW GRADIENT AORTIC VALVE STENOSIS
Creators: Mohamad Hemu - Rush University Medical Center
Caleb Chiang - Rush University Medical Center
Jaafar Alward - Rush University Medical Center
Konstantinos Voudris - Rush University Medical Center
Hussam Suradi - Rush University Medical Center
Resource Type: Abstract
Publication Details: Journal of the American College of Cardiology, Vol.77(18 Supplement 1), pp.1160-1160
DOI: 10.1016/S0735-1097(21)02519-5
ISSN: 0735-1097
Language: English
Date published: 05/11/2021
Academic Unit: Internal Medicine
Record Identifier: 9985218375702771

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