The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis
BackgroundCoronary artery disease (CAD) is a common finding in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). However, the impact on prognosis of chronic total occlusions (CTOs), a drastic expression of CAD, remains unclear.Methods and resultsWe retros...
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1338253/full |
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| author | Maximilian Will Maximilian Will Maximilian Will Konstantin Schwarz Konstantin Schwarz Thomas Weiss Thomas Weiss Gregor Leibundgut Elisabeth Schmidt Elisabeth Schmidt Paul Vock Paul Vock Roya Mousavi Roya Mousavi Josip A. Borovac Chun Shing Kwok Chun Shing Kwok Uta C. Hoppe Julia Mascherbauer Julia Mascherbauer Gudrun Lamm Gudrun Lamm |
| author_facet | Maximilian Will Maximilian Will Maximilian Will Konstantin Schwarz Konstantin Schwarz Thomas Weiss Thomas Weiss Gregor Leibundgut Elisabeth Schmidt Elisabeth Schmidt Paul Vock Paul Vock Roya Mousavi Roya Mousavi Josip A. Borovac Chun Shing Kwok Chun Shing Kwok Uta C. Hoppe Julia Mascherbauer Julia Mascherbauer Gudrun Lamm Gudrun Lamm |
| author_sort | Maximilian Will |
| collection | DOAJ |
| description | BackgroundCoronary artery disease (CAD) is a common finding in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). However, the impact on prognosis of chronic total occlusions (CTOs), a drastic expression of CAD, remains unclear.Methods and resultsWe retrospectively reviewed 1,487 consecutive TAVR cases performed at a single tertiary care medical center. Pre-TAVR angiograms were analyzed for the presence of a CTO. At the time of TAVR, 11.2% (n = 167) patients had a CTO. There was no significant association between the presence of a CTO and in-hospital or 30-day mortality. There was also no difference in long-term survival. LV ejection fraction and mean aortic gradients were lower in the CTO group.ConclusionsOur analysis suggests that concomitant CTO lesions in patients undergoing TAVR differ in their risk profile and clinical findings to patients without CTO. CTO lesion per se were not associated with increased mortality, nevertheless CTOs which supply non-viable myocardium in TAVR population were associated with increased risk of death. Additional research is needed to evaluate the prognostic significance of CTO lesions in TAVR patients. |
| first_indexed | 2024-03-07T22:52:53Z |
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| language | English |
| last_indexed | 2024-03-07T22:52:53Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-f11b5590504f4e5fb390d5ab1b590fa42024-02-23T08:21:22ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-02-011110.3389/fcvm.2024.13382531338253The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysisMaximilian Will0Maximilian Will1Maximilian Will2Konstantin Schwarz3Konstantin Schwarz4Thomas Weiss5Thomas Weiss6Gregor Leibundgut7Elisabeth Schmidt8Elisabeth Schmidt9Paul Vock10Paul Vock11Roya Mousavi12Roya Mousavi13Josip A. Borovac14Chun Shing Kwok15Chun Shing Kwok16Uta C. Hoppe17Julia Mascherbauer18Julia Mascherbauer19Gudrun Lamm20Gudrun Lamm21Karl Landsteiner University of Health Sciences, Krems, AustriaDivision of Internal Medicine 3, University Hospital St. Pölten, St. Pölten, AustriaKarl Landsteiner Institute for Cardiometabolics, Karl Landsteiner Society, St Poelten, AustriaKarl Landsteiner University of Health Sciences, Krems, AustriaDivision of Internal Medicine 3, University Hospital St. Pölten, St. Pölten, AustriaKarl Landsteiner Institute for Cardiometabolics, Karl Landsteiner Society, St Poelten, AustriaMedical School, Sigmund-Freud University, Vienna, AustriaKlinik für Kardiologie, Universitätsspital Basel, Basel, SwitzerlandKarl Landsteiner University of Health Sciences, Krems, AustriaDivision of Internal Medicine 3, University Hospital St. Pölten, St. Pölten, AustriaKarl Landsteiner University of Health Sciences, Krems, AustriaDivision of Internal Medicine 3, University Hospital St. Pölten, St. Pölten, AustriaKarl Landsteiner University of Health Sciences, Krems, AustriaDivision of Internal Medicine 3, University Hospital St. Pölten, St. Pölten, AustriaCardiovascular Diseases Department, University Hospital of Split, Split, CroatiaDepartment of Post-Qualifying Healthcare Practice, School of Nursing and Midwifery, Birmingham City University, Birmingham, United KingdomDepartment of Cardiology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United KingdomUniversity Department of Internal Medicine II, Cardiology and Internal Intensive Care Medicine, Paracelsus Medical University, Salzburg, AustriaKarl Landsteiner University of Health Sciences, Krems, AustriaDivision of Internal Medicine 3, University Hospital St. Pölten, St. Pölten, AustriaKarl Landsteiner University of Health Sciences, Krems, AustriaDivision of Internal Medicine 3, University Hospital St. Pölten, St. Pölten, AustriaBackgroundCoronary artery disease (CAD) is a common finding in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). However, the impact on prognosis of chronic total occlusions (CTOs), a drastic expression of CAD, remains unclear.Methods and resultsWe retrospectively reviewed 1,487 consecutive TAVR cases performed at a single tertiary care medical center. Pre-TAVR angiograms were analyzed for the presence of a CTO. At the time of TAVR, 11.2% (n = 167) patients had a CTO. There was no significant association between the presence of a CTO and in-hospital or 30-day mortality. There was also no difference in long-term survival. LV ejection fraction and mean aortic gradients were lower in the CTO group.ConclusionsOur analysis suggests that concomitant CTO lesions in patients undergoing TAVR differ in their risk profile and clinical findings to patients without CTO. CTO lesion per se were not associated with increased mortality, nevertheless CTOs which supply non-viable myocardium in TAVR population were associated with increased risk of death. Additional research is needed to evaluate the prognostic significance of CTO lesions in TAVR patients.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1338253/fullCoronary artery disease (CAD)aortic stenosis (AS)transcatheter aortic valve replacement (TAVR)chronic total occlusion (CTO)percutaneous coronary intervention (PCI) |
| spellingShingle | Maximilian Will Maximilian Will Maximilian Will Konstantin Schwarz Konstantin Schwarz Thomas Weiss Thomas Weiss Gregor Leibundgut Elisabeth Schmidt Elisabeth Schmidt Paul Vock Paul Vock Roya Mousavi Roya Mousavi Josip A. Borovac Chun Shing Kwok Chun Shing Kwok Uta C. Hoppe Julia Mascherbauer Julia Mascherbauer Gudrun Lamm Gudrun Lamm The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis Frontiers in Cardiovascular Medicine Coronary artery disease (CAD) aortic stenosis (AS) transcatheter aortic valve replacement (TAVR) chronic total occlusion (CTO) percutaneous coronary intervention (PCI) |
| title | The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis |
| title_full | The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis |
| title_fullStr | The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis |
| title_full_unstemmed | The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis |
| title_short | The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis |
| title_sort | impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement a large single center analysis |
| topic | Coronary artery disease (CAD) aortic stenosis (AS) transcatheter aortic valve replacement (TAVR) chronic total occlusion (CTO) percutaneous coronary intervention (PCI) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1338253/full |
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