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

• Published in: Aging clinical and experimental research 2023-02, Vol.35 (2), p.375-385
• Main Authors: Güzel, Tuncay, Demir, Muhammed, Aktan, Adem, Arık, Baran, Argun, Lokman, İldırımlı, Kamran, Sütcü, Mihriban, Arslan, Bayram, Özbek, Mehmet, Kılıç, Raif, Aslan, Burhan, Gitmez, Mesut, Karaçalılar, Mehmet, Çakır, Çayan, Ertaş, Faruk
• Format: Article
• Language: English
• Subjects: Aortic Valve - surgery; Aortic Valve Stenosis - surgery; Cardiac arrhythmia; Cardiology; Coronary vessels; Cross-Sectional Studies; Geriatrics/Gerontology; Heart attacks; Heart Valve Prosthesis - adverse effects; Hospitals; Humans; Medicine; Medicine & Public Health; Mortality; Original Article; Pacemaker, Artificial - adverse effects; Pacemakers; Patients; Retrospective Studies; Stroke; Tomography; Transcatheter Aortic Valve Replacement - adverse effects; Treatment Outcome
• ISSN: 1720-8319; 1594-0667; 1720-8319
• DOI: 10.1007/s40520-022-02307-5

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