Procedural data and Doppler echocardiographic data post-ViV according to the presence or absence of suboptimal aortic valve haemodynamic performance after ViV
| Whole cohort | Valve haemodynamics after ViV | P values | ||
| n=79 | Adequate: MG <20 mm Hg and AR ≤mild n=31 (39.2%) | Suboptimal: MG ≥20 mm Hg and/or AR ≥moderate n=48 (60.8%) | ||
| Procedural data | ||||
| Balloon-expandable THV, n (%) | 49 (62.0) | 19 (61.3) | 30 (62.5) | 0.914 |
| THV size (≤23), n (%) | 55 (69.6) | 19 (61.3) | 36 (75.0) | 0.196 |
| THV model, n (%) | 0.484 | |||
| SAPIEN/XT/3 | 49 (62.0) | 19 (61.3) | 30 (62.5) | |
| CoreValve/Evolut R | 28 (35.4) | 12 (38.7) | 16 (33.3) | |
| Portico | 2 (2.5) | 0 (0.0) | 2 (4.2) | |
| Access, n (%) | 0.224 | |||
| Transfemoral | 47 (59.5) | 16 (51.6) | 31 (64.6) | |
| Transapical | 23 (29.1) | 12 (38.7) | 11 (22.9) | |
| Transcarotid | 6 (7.6) | 1 (3.2) | 5 (10.4) | |
| Transaortic | 3 (3.8) | 2 (6.5) | 1 (2.1) | |
| Procedural success*, n (%) | 62 (78.5) | 24 (77.4) | 38 (79.2) | 0.854 |
| Coronary occlusion, n (%) | 1 (1.3) | 0 (0) | 1 (2.1) | 1.0 |
| More than one THV, n (%) | 8 (10.1) | 3 (9.7) | 5 (10.4) | 1.0 |
| Need of pacemaker, n (%) | 3 (3.8) | 0 (0.0) | 3 (6.3) | 0.276 |
| New onset of atrial fibrillation, n (%) | 5 (6.8) | 2 (6.7) | 3 (6.8) | 1.0 |
| Major vascular complication, n (%) | 2 (2.5) | 1 (3.2) | 1 (2.1) | 1.0 |
| Major bleeding, n (%) | 3 (3.8) | 1 (3.2) | 2 (4.2) | 1.0 |
| THV malposition or embolisation, n (%) | 2 (2.5) | 0 (0.0) | 2 (4.2) | 0.517 |
| Hospital stay, days | 6.9±4.9 | 7.7±5.5 | 6.3±4.4 | 0.214 |
| Doppler echocardiographic data post-ViV | ||||
| MG, mm Hg | 22.2±9.3 | 14.1±3.9 | 27.3±8.0 | <0.0001 |
| EOA, cm2 | 1.15±0.38 | 1.29±0.29 | 1.06±0.40 | 0.009 |
| EOAi, cm2/m2 | 0.62±0.21 | 0.73±0.18 | 0.56±0.20 | 0.0003 |
| Doppler velocity index | 0.30±0.08 | 0.34±0.08 | 0.27±0.07 | <0.0001 |
| PPM, n (%) | <0.0001 | |||
| None | 11 (13.9) | 8 (25.8) | 3 (6.3) | |
| Moderate | 14 (17.7) | 12 (38.7) | 2 (4.2) | |
| Severe | 54 (68.4) | 11 (35.5) | 43 (89.6) | |
| LVEF, % | 57.5±11.7 | 55.8±10.7 | 58.7±11.7 | 0.584 |
| Stroke volume, mL | 70.2±18.5 | 72.0±24.0 | 67.9±14.2 | 0.684 |
| AR, n (%) | 0.035 | |||
| None | 26 (33.3) | 8 (26.7) | 18 (37.5) | |
| Trace | 39 (50.0) | 16 (53.3) | 23 (47.9) | |
| Mild | 10 (12.8) | 6 (20.0) | 4 (8.3) | |
| Moderate | 3 (3.9) | 0 (0.0) | 3 (6.3) | |
| Severe | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Suboptimal valve function | ||||
| MG ≥20 mm Hg, n (%) | 45 (57.0) | 0 (0.0) | 45 (93.8) | – |
| AR ≥moderate, n (%) | 3 (3.9) | 0 (0.0) | 3 (6.3) | – |
| Change from pre-ViV | ||||
| ΔMG, mm Hg | −14.4±18.3 | −13.7±16.6 | −14.8±19.5 | 0.806 |
| ΔEOA, cm2 | +0.10±0.47 | +0.07±0.62 | +0.12±0.36 | 0.646 |
| ΔEOAi, cm2/m2 | +0.05±0.26 | +0.04±0.35 | +0.06±0.19 | 0.698 |
| ΔAR, grade | −1.8±1.4 | −2.1±1.4 | −1.6±1.3 | 0.104 |
| Change from post-SAVR | ||||
| ΔMG, mm Hg | +7.8±7.9 | +3.5±4.9 | +10.8±8.3 | 0.0003 |
| ΔEOA, cm2 | −0.44±0.40 | −0.42±0.40 | −0.46±0.40 | 0.668 |
| ΔEOAi, cm2/m2 | −0.24±0.21 | −0.23±0.22 | −0.24±0.21 | 0.873 |
| ΔAR, grade | +0.28±0.91 | +0.13±0.66 | +0.38±1.02 | 0.359 |
*Procedural success was defined as the absence of any major adverse cardiovascular and cerebrovascular event (stroke, myocardial infarction, in-hospital death) and device success (no more than one transcatheter prosthesis, no procedural death and no vascular complication).
AR, aortic regurgitation; EOA, effective orifice area; EOAi, indexed EOA; LVEF, left ventricular ejection fraction; MG, mean transvalvular pressure gradient; PPM, prosthesis–patient mismatch; SAVR, surgical aortic valve replacement; THV, transcatheter heart valve; ViV, valve-in-valve implantation.