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Impact of balloon post-dilation on valve durability and long-term clinical outcomes after self-expanding transcatheter aortic valve implantation

Title: Impact of balloon post-dilation on valve durability and long-term clinical outcomes after self-expanding transcatheter aortic valve implantation
Authors: Sanz Sanchez J.; Regazzoli D.; Barbanti M.; Fiorina C.; Adamo M.; Angelillis M.; De Carlo M.; Bellini B.; Montorfano M.; Mangieri A.; Bruschi G.; Merlanti B.; Agnifili M. L.; Testa L.; Ferrara E.; Musto C.; Colombo A.; Tamburino C.; Reimers B.
Contributors: Sanz Sanchez, J.; Regazzoli, D.; Barbanti, M.; Fiorina, C.; Adamo, M.; Angelillis, M.; De Carlo, M.; Bellini, B.; Montorfano, M.; Mangieri, A.; Bruschi, G.; Merlanti, B.; Agnifili, M. L.; Testa, L.; Ferrara, E.; Musto, C.; Colombo, A.; Tamburino, C.; Reimers, B.
Publisher Information: John Wiley and Sons Inc
Publication Year: 2024
Subject Terms: balloon post-dilation; TAVI; valve degeneration plus; valve durability
Description: Background: Balloon post-dilation (BPD) is a widely adopted strategy to optimize acute results of TAVI, with a positive impact on both paravalvular leak and mean gradients. On the other hand, the inflation of the balloon inside prosthetic leaflets may damage them increasing the risk of structural valve deterioration (SVD). Furthermore, the impact of BPD on long-term clinical outcomes and valve hemodynamics is yet unknown. Aims: To evaluate the impact of BPD on valve durability and long-term clinical outcomes in patients undergoing self-expanding transcatheter valve implantation (TAVI). Methods: Echocardiographic and clinical data from the ClinicalService (a nation-based data repository and medical care project) were analyzed. Patients were divided into two groups, those who underwent BPD after TAVI and those who did not. Coprimary endpoints were all-cause death and SVD. Cumulative incidence functions for SVD were estimated. Results: Among 1835 patients included in the study, 417 (22.7%) underwent BPD and 1418 (77.3%) did not undergo BPD. No statistically significant differences at 6-year follow-up were found between groups in terms of all-cause mortality (HR: 1.05, 95% CI: 0.9–1.22; p = 0.557) and SVD (2.1% vs. 1.4%, p = 0.381). In addition, BPD did not predispose to higher risk of cardiovascular death, myocardial infarction, valve thrombosis, and endocarditis at 6-year follow-up. Conclusions: BPD following TAVI with a self-expanding prosthesis does not seem to be associated with an increased risk of adverse clinical outcomes or SVD at 6-year follow-up.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/37957842; info:eu-repo/semantics/altIdentifier/wos/WOS:001101594200001; volume:103; issue:1; firstpage:209; lastpage:218; numberofpages:10; journal:CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS; https://hdl.handle.net/20.500.11768/170396
DOI: 10.1002/ccd.30907
Availability: https://hdl.handle.net/20.500.11768/170396; https://doi.org/10.1002/ccd.30907; https://onlinelibrary.wiley.com/doi/10.1002/ccd.30907
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.B36D6004
Database: BASE