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Valvular heart disease
Original research
Impact of significant paravalvular leaks after transcatheter aortic valve implantation on anaemia and mortality
  1. Javier Lopez-Pais1,2,
  2. Diego Lopez-Otero1,2,
  3. Arturo Garcia-Touchard3,
  4. Barbara Izquierdo Coronel4,
  5. Pablo José Antúnez Muiños5,
  6. Xabier Cia Mendioroz3,
  7. Marta Pérez-Poza5,
  8. Óscar Otero Garcia5,
  9. Carlos Gustavo Martinez Peredo6,
  10. Carlos Arellano Flores7,
  11. Leyre Álvarez-Rodríguez5,
  12. Fernando Gomez Peña8,
  13. Mária Juskova5,
  14. Juan Carlos Sanmartín Pena1,
  15. Rodrigo Estevez-Loureiro9,
  16. Ana Belén Cid Álvarez1,
  17. Ramiro Trillo Nouche1,
  18. Joaquín Jesús Alonso-Martín10,
  19. Jose Ramón González-Juanatey2,5,
  20. Juan Francisco Oteo3
  21. On behalf of Von-TAVI investigators
  1. 1 Interventional Cardiology, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
  2. 2 CIBERCV, Santiago, Spain
  3. 3 Puerta del Hierro University Hospital of Majadahonda, Majadahonda, Madrid, Spain
  4. 4 Hospital Universitario de Getafe, Getafe, Madrid, Spain
  5. 5 Cardiology, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
  6. 6 CHR Mons-Hainaut, Mons, Hainaut, Belgium
  7. 7 Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
  8. 8 Hospital de Cardiología Centro Médico Nacional Siglo XXI, Mexico City, Mexico
  9. 9 Interventional Cardiology, Hospital Álvaro Cunqueiro, Vigo, Galicia, Spain
  10. 10 Cardiology, Hospital Universitario de Getafe, Getafe, Madrid, Spain
  1. Correspondence to Dr Juan Francisco Oteo, Puerta del Hierro University Hospital of Majadahonda, Majadahonda, Madrid, Spain; Jfoteod{at}hotmail.com

Abstract

Objective The aim of this work is to assess the relationship between significant paravalvular leak (SPL) after transcatheter aortic valve implantation (TAVI) on anaemia and their impact on prognosis.

Methods Observational analytic study developed at two university hospitals, including all consecutive patients who underwent TAVI during a 10-year period (2009 to 2018). A logistic regression model was created to determine independent predictors of anaemia at 3 months. Time to event outcomes were analysed with Cox regression. Median follow-up was 21.3±21.9 months.

Results 788 patients were included. 5.3% had SPL. SPL was an independent predictor of anaemia 3 months after TAVI (OR: 8.31, 95% CI: 2.06 to 33.50). SPL and anaemia at 3 months were independently associated with long-term mortality (HR: 1.82, 95% CI: 1.16 to 2.85; HR: 2.07, 95% CI: 1.39 to 3.08).

Conclusion SPL is an independent predictor of anaemia at 3 months after TAVI, a condition that doubles long-term mortality. Our findings could explain in part the worse prognosis of SPL after TAVI. Further pathophysiological studies are necessary to explain this association.

  • endovascular procedures for aortic and vascular disease

https://doi.org/10.1136/heartjnl-2020-316941

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    Footnotes

    • Twitter @javierlopezpais, @birihh, @BebbeBarbara, @pjantunez, @jaborro3, @fergomezp23, @RodrigoEstvez1, @belcid7, @ramirotrillo, @JoseJuanatey

    • Contributors JL-P, DL-O, JFOD, BIC and PJAM contributed to the conception or design of the work and final approval of the version to be published. JFOD, XCM, MP-P, AG-T, OOG, CCMP, CAF, LA-R, FGP and MJ contributed to the data collection. JL-P, DLO, MP-P, OOG, AGT and PJAM contributed to the data analysis and interpretation. JL-P and DLO drafted the article. AGT, JCSP, ABCA, RTN, JJAM, JRG-J and JFOD contributed to the critical revision of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Ethics approval Comite Autonómico de Ética da Investigación de Santiago ID: 2018/495.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. For any other data contact: Email: javierlopezpais@gmail.com. Address: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, rúa da Choupana s/n, 15703, Santiago de Compostela, Galicia, España.