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Damas F, Nguyen Trung ML, Postolache A, Petitjean H, Lempereur M, Viva T, Oury C, Dulgheru R, Lancellotti P. Cardiac Damage and Conduction Disorders after Transcatheter Aortic Valve Implantation. J Clin Med 2024; 13:409. [PMID: 38256543 PMCID: PMC10816504 DOI: 10.3390/jcm13020409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Recently, a staging system using 4 grades has been proposed to quantify the extent of cardiac damage associated with aortic stenosis (AS), namely AS-related cardiac damage staging (ASCDS). ASCDS is independently associated with all-cause mortality and important clinical outcomes. To evaluate whether it might be associated with the occurrence of conduction system disorders after TAVI, a total of 119 symptomatic patients with severe AS who underwent a TAVI were categorized according to ASCDS: group 1 (13.5%): no or LV damage; group 2 (58.8%): left atrial/mitral valve damage, atrial fibrillation (AF); group 3 (27.7%): low-flow state, pulmonary vasculature/tricuspid valve/RV damage. After TAVI, 34% of patients exhibited LBBB and 10% high-degree atrioventricular block (HD-AVB). No patient in group 1 developed HD-AVB whereas new LBBB was frequent in groups 2 and 3. Twenty-one patients presented with paroxysmal AF with a higher rate for each group increment (group 1: n = 0, 0%; group 2: n = 11, 15.7%; group 3: n = 10, 30.3%) (p = 0.012). Patients in group 3 had the higher rate of permanent pacemaker implantation (PPMI) (group 1: n = 1, 6.3%; group 2: n = 7, 10%; group 3: n = 9, 27.3%) (p = 0.012). In conclusion, ASCDS might help identify patients at higher risk of conduction disorders and PPMI requirement after TAVI.
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Affiliation(s)
- François Damas
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Mai-Linh Nguyen Trung
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Adriana Postolache
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Hélène Petitjean
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Mathieu Lempereur
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Tommaso Viva
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
- Department of Minimally Invasive Cardiac Surgery, University of Milan, 20122 Milan, Italy
- IRCCS Galeazzi, Sant’Ambrogio Hospital, 20157 Milan, Italy
| | - Cécile Oury
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Raluca Dulgheru
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Patrizio Lancellotti
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
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