Effects of Two Types of Prosthetic Valves For Transcatheter Aortic Valve Implantation On Intraoperative Left Ventricular End-diastolic Pressure

Abstract

Background: Transcatheter aortic valve implantation (TAVI) is intended to reduce left ventricular afterload and the concomitant left ventricular end-diastolic pressure (LVEDP) change. Currently, two types of prosthetic valves are used in the TAVI procedures: balloon-expandable valves and self-expandable valves. The purpose of the current study was to investigate the effects of these valves on the LVEDP after valve deployment. Methods: This retrospective study included 181 patients who underwent transfemoral TAVI. The patients were classified into one of two groups according to whether a balloon-expandable prosthetic valve (group B) or self-expandable prosthetic valve (group S) was used in the procedure. The intraoperative LVEDP, measured using an intracardiac catheter, was compared before and after valve deployment. Results: The LVEDP decrement was significantly greater for group S than for group B (-1.3 ± 6.0 mmHg vs. 0.8 ± 5.1 mmHg). A subgroup analysis of the patients with mild or lower grade aortic regurgitation showed a significantly greater decrement of the LVEDP for subgroup S than for subgroup B (-1.8 ± 5.6 mmHg vs. 0.5 ± 4.8 mmHg). Conclusion: Self-expandable prosthetic valves are advantageous for preventing LVEDP elevation after TAVI compared to balloon expandable prosthetic valves. The study was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN000040255).

Keywords

• tavi
• lvedp
• self-expandable prosthetic valve
• balloon-expandable prosthetic valve