PT  - JOURNAL ARTICLE
AU  - Giulia Esposito
AU  - Niraj Kumar
AU  - Francesca Pugliese
AU  - Max Sayers
AU  - Anthony WC Chow
AU  - Simon Kennon
AU  - Mick Ozkor
AU  - Anthony Mathur
AU  - Andreas Baumbach
AU  - Guy Lloyd
AU  - Aigerim Mullen
AU  - Andrew Cook
AU  - Michael Mullen
AU  - Kush P Patel
TI  - Predictors of post-TAVI conduction abnormalities in patients with bicuspid aortic valves
AID  - 10.1136/openhrt-2022-001995
DP  - 2022 Jul 01
TA  - Open Heart
PG  - e001995
VI  - 9
IP  - 2
4099  - http://openheart.bmj.com/content/9/2/e001995.short
4100  - http://openheart.bmj.com/content/9/2/e001995.full
SO  - Open Heart2022 Jul 01; 9
AB  - Objectives This study evaluates predictors of conduction abnormalities (CA) following transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic valves (BAV).Background TAVI is associated with CA that commonly necessitate a permanent pacemaker. Predictors of CA are well established among patients with tricuspid aortic valves but not in those with BAV.Methods This is a single-centre, retrospective, observational study of patients with BAV treated with TAVI. Pre-TAVI ECG and CT scans and procedural characteristics were evaluated in 58 patients with BAV. CA were defined as a composite of high-degree atrioventricular block, new left bundle branch block with a QRS >150 ms or PR >240 ms and right bundle branch block with new PR prolongation or change in axis. Predictors of CA were identified using regression analysis and optimum cut-off values determined using area under the receiver operating characteristic curve analysis.Results CA occurred in 35% of patients. Bioprosthesis implantation depth, the difference between membranous septum (MS) length and implantation depth (δMSID) and device landing zone (DLZ) calcification adjacent to the MS were identified as univariate predictors of CA. The optimum cut-off for δMSID was 1.25 mm. Using this cut-off, low δMSID and DLZ calcification adjacent to MS predicted CA, adjusted OR 8.79, 95% CI 1.88 to 41.00; p=0.01. Eccentricity of the aortic valve annulus, type of BAV and valve calcium quantity and distribution did not predict CA.Conclusions In BAV patients undergoing TAVI, short δMSID and DLZ calcification adjacent to MS are associated with an increased risk of CA.No data are available. Data for this study are not available for sharing due to confidentiality reasons.