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A new trend to reduce adverse events in patients undergoing transcatheter aortic valve implantation: cusp overlap technique: a cross sectional study

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Abstract

Background

Transcatheter aortic valve implantation (TAVI) is currently the treatment of choice for the majority of patients at moderate or high surgical risk. However, some complications occur frequently with this procedure. In this study, we aimed to assess whether the cusp-overlap view (COP) technique may be associated with a reduced incidence of some of these complications compared with the classical three-cusp view (TCV) technique.

Methods

In this single-center, retrospective study we investigated; technical success, postprocedural permanent pacemaker implantation (PPMI), new-onset stroke, pericardial tamponade, arrhythmia development, acute renal failure, major bleeding, major vascular complications, procedure-related coronary obstruction, new-onset left bundle branch block (LBBB), paravalvular leak, peri-procedural myocardial infarction (MI), day of hospitalization, death, and major adverse cardiac and cerebrovascular events (MACCE) were determined as the clinical endpoints.

Results

A total of 281 consecutive patients who met the study criteria and underwent elective or emergency transfemoral TAVI using the self-expandable CoreValve Evolut valve were included. 176 consecutive patients implanted with the classical TCV technique and 105 consecutive patients implanted with the COP technique were compared. Compared with the TCV group, patients in the COP group had lower PPMI (3.8% vs. 10.8%, p = 0.039), in-hospital mortality (1.9% vs. 8.5%, p = 0.018), and 1-year death (4.8% versus 18.8%, p = 0.001), and MACCE rates (12.4% vs 31.3%, p < 0.001).

Conclusion

The COP technique may help to reduce the conduction disturbances, PPMI requirement and complication rates that may develop following TAVI. In addition, it is an interesting result that it reduces mortality and MACCE rates in long-term follow-ups.

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Data availability

The data are available from the authors upon reasonable request.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Cardiology, Health Science University, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey

    Tuncay Güzel & Burhan Aslan

  2. Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey

    Muhammed Demir, Baran Arık, Lokman Argun, Kamran İldırımlı, Mihriban Sütcü, Mehmet Özbek & Faruk Ertaş

  3. Department of Cardiology, Mardin Training and Research Hospital, Mardin, Turkey

    Adem Aktan

  4. Department of Cardiology, Ergani State Hospital, Diyarbakir, Turkey

    Bayram Arslan

  5. Department of Cardiology, Diyarlife Hospital, Diyarbakir, Turkey

    Raif Kılıç

  6. Department of Cardiology, Batman Training and Research Hospital, Batman, Turkey

    Mesut Gitmez

  7. Department of Cardiovascular Surgery, Faculty of Medicine, Dicle University, Diyarbakir, Turkey

    Mehmet Karaçalılar

  8. Department of Cardiology, Bismil State Hospital, Diyarbakir, Turkey

    Çayan Çakır

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  1. Tuncay Güzel
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  2. Muhammed Demir
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  13. Mehmet Karaçalılar
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  14. Çayan Çakır
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  15. Faruk Ertaş
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Corresponding author

Correspondence to Tuncay Güzel.

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Conflict of ınterest

The authors declare that there is no conflict of interest.

Compliance with Ethical Standards

This study was performed in line with the principles of the Declaration of Helsinki.

Ethical approval

Approval was granted by the Dicle University Ethics Committee (date and number: 17/03/2022-71).

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Informed consent was obtained by patients.

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Güzel, T., Demir, M., Aktan, A. et al. A new trend to reduce adverse events in patients undergoing transcatheter aortic valve implantation: cusp overlap technique: a cross sectional study. Aging Clin Exp Res 35, 375–385 (2023). https://doi.org/10.1007/s40520-022-02307-5

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  • DOI: https://doi.org/10.1007/s40520-022-02307-5

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