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Saji M, Highchi R, Iguchi N, Takamisawa I, Shimizu J, Shimokawa T, Nanasato M, Takayama M, Isobe M. Combination Use of Inoue-Balloon and Self-Expandable Transcatheter Valves in Managing Aortic Stenosis Not Amenable to Balloon-Expandable Valves. Int Heart J 2022; 63:843-851. [DOI: 10.1536/ihj.22-220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Mike Saji
- Department of Cardiology, Sakakibara Heart Institute
| | | | - Nobuo Iguchi
- Department of Cardiology, Sakakibara Heart Institute
| | | | - Jun Shimizu
- Department of Anesthesiology, Sakakibara Heart Institute
| | - Tomoki Shimokawa
- Department of Cardiovascular Surgery, Sakakibara Heart Institute
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Elnaggar HM, Schoels W, Mahmoud MS, Kishk YT, Kullmer M, Dia M, Algowhary M. Impact of balloon predilatation in patients with reduced versus preserved ejection fraction during transcatheter aortic valve implantation. Asian Cardiovasc Thorac Ann 2022; 30:985-991. [DOI: 10.1177/02184923221126086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Although there is a trend toward direct transcatheter aortic valve implantation (TAVI), still balloon predilatation is necessary in some cases, especially in patients with severe calcification. However, predilatation including rapid ventricular pacing may have adverse outcomes, especially in patients with reduced ejection factor (EF). Objective To evaluate the impact of predilatation on in-hospital outcomes in patients with reduced versus preserved EF underwent TAVI. Methods This was a prospective observational study including 110 patients (72 patients with preserved EF (≥50%) and 38 patients with reduced EF (<50%)) who underwent TAVI. The two groups were compared regarding in-hospital outcomes. Results Predilatation was done routinely in all 110 patients. The mean age was significantly higher in patients with preserved EF (82.76 ± 5.74 vs. 80.13 ± 6.51 years; p = 0.03). The majority (51.4%) of patients with preserved EF were females but the majority (73.7%) of those with reduced EF were males ( P < 0.001). Predilatation showed no statistical difference regarding in-hospital mortality (2.6% vs. 1.4%; p = 0.29), hemodynamic instability (5.3% vs. 0.0%; p = 0.11), stroke (0% vs. 1.4%; p = 0.67), conduction defects (13.2% vs. 19.4%; p = 0.29), permanent pacemaker implantation (7.9% vs. 5.5%; p = 0.45), paravalvular leakage (5.3% vs. 2.8%; p = 0.42), vascular complications (7.9% vs. 11.1%; p = 0.43), and acute kidney injury (7.9% vs. 7%; p = 0.4) in patients with reduced versus preserved EF, respectively. Conclusion When balloon predilatation is inevitable during TAVI it is safe in patients with reduced as well as preserved EF with no added risk of hemodynamic instability or other outcomes.
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Affiliation(s)
- Heba M. Elnaggar
- Cardiology Department, Assiut University Heart Hospital, Assiut University, Assiut, Egypt
| | | | - Marwan S. Mahmoud
- Cardiology Department, Assiut University Heart Hospital, Assiut University, Assiut, Egypt
- Cardiology Department, Duisburg Heart Center, Duisburg, Germany
| | - Yehia T. Kishk
- Cardiology Department, Assiut University Heart Hospital, Assiut University, Assiut, Egypt
| | | | - Mohamad Dia
- Cardiac Surgery Department, Duisburg Heart Center, Duisburg, Germany
| | - Magdy Algowhary
- Cardiology Department, Assiut University Heart Hospital, Assiut University, Assiut, Egypt
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