Changes of ascending aortic diameter after transcatheter aortic valve replacement_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

AN Kang , ZHANG Fengwen , OUYANG Wenbin , XU Donghui ,  PAN Xiangbin

Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China;

Corresponding author：

PAN Xiangbin, Email: panxiangbin@fuwaihospital.org

Keywords：

Transcatheter aortic valve replacement; annual dilation rate of ascending aorta; adverse aortic events

DOI：

10.7507/1007-4848.202202018

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the changes of ascending aortic (AA) diameter after transcatheter aortic valve replacement (TAVR), and evaluate the safety and efficacy of TAVR in patients with AA dilation. Methods We retrospectively included 87 patients who underwent TAVR at our center from 2016 to 2019. These patients were divided into 2 groups based on the preoperative AA diameter. There were 17 patients in the AA diameter≥45 mm group (including 10 males, aged 74.4±5.6 years), and 70 patients in the AA diameter<45 mm group (including 39 males, aged 75.9±7.0 years). Results The baseline variables were similar between two groups (P>0.05). The overall device success rate was 97.7% (85/87). The median computed tomography (CT) follow-up time was 24.2±11.8 months in patients with AA diameter≥45 mm and 23.0±10.7 months in patients with AA diameter<45 mm, and the median annual dilation rate of AA were 0.36 mm/year and 0.00 mm/year, respectively. No statistical significance was observed between two groups (P>0.05). No adverse aortic events occurred during the follow-up period. Conclusion TAVR is safe and effective in patients with preoperative AA diameter≥45 mm, and the AA diameter remains stable after the procedure. Patients with preoperative AA diameter≥45 mm and AA diameter<45 mm have similar annual dilation rates.

Citation： AN Kang, ZHANG Fengwen, OUYANG Wenbin, XU Donghui, PAN Xiangbin. Changes of ascending aortic diameter after transcatheter aortic valve replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(11): 1455-1459. doi: 10.7507/1007-4848.202202018 Copy

1.	Mack MJ, Leon MB, Smith CR, et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): A randomised controlled trial. Lancet, 2015, 385(9986): 2477-2484.
2.	Siontis GCM, Overtchouk P, Cahill TJ, et al. Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: An updated meta-analysis. Eur Heart J, 2019, 40(38): 3143-3153.
3.	Leon MB, Smith CR, Mack MJ, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med, 2016, 374(17): 1609-1620.
4.	Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med, 2019, 380(18): 1695-1705.
5.	张怡, 熊恬园, 陈茂. 《2021ESC/EACTS心脏瓣膜病管理指南》解读: 经导管瓣膜治疗策略的更新. 中国胸心血管外科临床杂志, 2021, 28(12): 1400-1408.
6.	Son JY, Ko SM, Choi JW, et al. Measurement of the ascending aorta diameter in patients with severe bicuspid and tricuspid aortic valve stenosis using dual-source computed tomography coronary angiography. Int J Cardiovasc Imaging, 2011, 27 Suppl 1: 61-71.
7.	Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2021, 77(4): e25-e197.
8.	Stock S, Mohamed SA, Sievers HH. Bicuspid aortic valve related aortopathy. Gen Thorac Cardiovasc Surg, 2019, 67(1): 93-101.
9.	Verma S, Siu SC. Aortic dilatation in patients with bicuspid aortic valve. N Engl J Med, 2014, 370(20): 1920-1929.
10.	Hager A, Kaemmerer H, Rapp-Bernhardt U, et al. Diameters of the thoracic aorta throughout life as measured with helical computed tomography. J Thorac Cardiovasc Surg, 2002, 123(6): 1060-1066.
11.	Wolak A, Gransar H, Thomson LE, et al. Aortic size assessment by noncontrast cardiac computed tomography: Normal limits by age, gender, and body surface area. JACC Cardiovasc Imaging, 2008, 1(2): 200-209.
12.	Lv WY, Zhao ZG, Li SJ, et al. Progression of the ascending aortic diameter after transcatheter aortic valve implantation: Based on computed tomography images. J Invasive Cardiol, 2019, 31(8): E234-E241.
13.	He YX, Fan JQ, Zhu QF, et al. Ascending aortic dilatation rate after transcatheter aortic valve replacement in patients with bicuspid and tricuspid aortic stenosis: A multidetector computed tomography follow-up study. World J Emerg Med, 2019, 10(4): 197-204.
14.	Rylski B, Szeto WY, Bavaria JE, et al. Transcatheter aortic valve implantation in patients with ascending aortic dilatation: Safety of the procedure and mid-term follow-up. Eur J Cardiothorac Surg, 2014, 46(2): 228-233.
15.	徐晓斌. 升主动脉结构特点对TAVR预后影响及TAVR术后升主动脉内径变化研究. 浙江大学, 2017.

1. Mack MJ, Leon MB, Smith CR, et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): A randomised controlled trial. Lancet, 2015, 385(9986): 2477-2484.
2. Siontis GCM, Overtchouk P, Cahill TJ, et al. Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: An updated meta-analysis. Eur Heart J, 2019, 40(38): 3143-3153.
3. Leon MB, Smith CR, Mack MJ, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med, 2016, 374(17): 1609-1620.
4. Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med, 2019, 380(18): 1695-1705.
5. 张怡, 熊恬园, 陈茂. 《2021ESC/EACTS心脏瓣膜病管理指南》解读: 经导管瓣膜治疗策略的更新. 中国胸心血管外科临床杂志, 2021, 28(12): 1400-1408.
6. Son JY, Ko SM, Choi JW, et al. Measurement of the ascending aorta diameter in patients with severe bicuspid and tricuspid aortic valve stenosis using dual-source computed tomography coronary angiography. Int J Cardiovasc Imaging, 2011, 27 Suppl 1: 61-71.
7. Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2021, 77(4): e25-e197.
8. Stock S, Mohamed SA, Sievers HH. Bicuspid aortic valve related aortopathy. Gen Thorac Cardiovasc Surg, 2019, 67(1): 93-101.
9. Verma S, Siu SC. Aortic dilatation in patients with bicuspid aortic valve. N Engl J Med, 2014, 370(20): 1920-1929.
10. Hager A, Kaemmerer H, Rapp-Bernhardt U, et al. Diameters of the thoracic aorta throughout life as measured with helical computed tomography. J Thorac Cardiovasc Surg, 2002, 123(6): 1060-1066.
11. Wolak A, Gransar H, Thomson LE, et al. Aortic size assessment by noncontrast cardiac computed tomography: Normal limits by age, gender, and body surface area. JACC Cardiovasc Imaging, 2008, 1(2): 200-209.
12. Lv WY, Zhao ZG, Li SJ, et al. Progression of the ascending aortic diameter after transcatheter aortic valve implantation: Based on computed tomography images. J Invasive Cardiol, 2019, 31(8): E234-E241.
13. He YX, Fan JQ, Zhu QF, et al. Ascending aortic dilatation rate after transcatheter aortic valve replacement in patients with bicuspid and tricuspid aortic stenosis: A multidetector computed tomography follow-up study. World J Emerg Med, 2019, 10(4): 197-204.
14. Rylski B, Szeto WY, Bavaria JE, et al. Transcatheter aortic valve implantation in patients with ascending aortic dilatation: Safety of the procedure and mid-term follow-up. Eur J Cardiothorac Surg, 2014, 46(2): 228-233.
15. 徐晓斌. 升主动脉结构特点对TAVR预后影响及TAVR术后升主动脉内径变化研究. 浙江大学, 2017.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Changes of ascending aortic diameter after transcatheter aortic valve replacement

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content