Transcatheter aortic valve implantation in obese patients: Overcoming technical challenges and maintaining adequate hemodynamic performance using new generation prostheses

2016 ◽  
Vol 220 ◽  
pp. 909-913 ◽  
Author(s):  
Stephan Kische ◽  
Giuseppe D'Ancona ◽  
Hüseyin U. Agma ◽  
Gihan El-Achkar ◽  
Martin Dißmann ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Obese Patients ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Technical Challenges ◽  
Hemodynamic Performance ◽  
Valve Implantation ◽  
New Generation

scholarly journals Obesity Paradox: Pulmonary Complications Rather than Mortality after Transcatheter Aortic Valve Implantation?

2021 ◽  
Author(s):  
Zeng-Rong Luo ◽  
Han-Fan Qiu ◽  
Liang-wan Chen
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Obesity Paradox ◽  
Pulmonary Complications ◽  
Normal Weight ◽  
Obese Patients ◽  
Intubation Time ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Background: Transcatheter aortic valve implantation (TAVI) for symptomatic aortic stenosis (AS) is considered a minimally invasive procedure. Body mass index (BMI) has been rarely evaluated for pulmonary complications after TAVI. This study aimed to assess the influence of BMI on the pulmonary complications and other related outcomes after TAVI. Methods: The clinical data of 109 patients who underwent TAVI in our hospital from May 2018 to April 2021 were retrospectively analyzed. Patients were divided into three groups according to BMI: normal weight (BMI <24.0kg/m2, n=54), overweight (BMI 24.0-27.9kg/m2, n=41) and obesity (BMI >28kg/m2, n=14) and two groups according to vascular access: through femoral artery route (TF-TAVI) (n=94) and through the transapical route (TA-TAVI) (n=15). Procedure endpoints, procedure success, and adverse outcomes were evaluated according to the Valve Academic Research Consortium (VARC)-2 definitions. Results: Obese patients had higher proportion of older (p <0.01) and previous percutaneous coronary intervention patients (p <0.01) and higher percentage of diabetes mellitus (p = 0.016) and frailty (p = 0.024), lower level of glomerular filtration rate (p <0.01). Procedure success was found similar between the three groups. 30-day all-cause mortality of patients with normal weight, overweight, and obesity was 3.7% (2/54) vs 4.9% (2/41) vs 7.1% (1/14) , respectively. In the multivariable analysis, overweight and obese patients exhibited similar overall mortality (overweight vs normal, p = 0.550 and obese vs normal, p = 0.763) and similar intubation time compared to normal weight patients (9.3±5.2 hours vs 9.0±6.2 hours vs 8.8±4.3 hours in obesity, overweight, and normal weight patients, respectively, p = 0.699). Although obese patients had lower PaO2/FiO2 than the normal weight patients at baseline, transitional extubation and postextubation 12th hour (p=0.046, 0.036, 0.047 respectively), there was no difference at postextubation 24th hour, postextubation 48th hour and postextubation 72th hour ( p= 0.778, 0.866, 0.886 respectively). Chronic lung disease (OR=7.986, p=0.001) rather than obesity (OR=1.967, p=0.132) or overweight (OR=3.046, p=0.081) affected postoperative PaO2/FiO2 after TAVI. Conclusions: We did not found the existence of an obesity paradox after TAVI. BMI showed no effect on the postoperative intubation time. Patients with a higher BMI should be treated equally and do not need to deliberately extend the intubation time for TAVI.

Impact of Predilation Before Transcatheter Aortic Valve Implantation with New-Generation Devices

2019 ◽  
Vol 20 (12) ◽  
pp. 1096-1099 ◽  
Author(s):  
Arturo Giordano ◽  
Nicola Corcione ◽  
Paolo Ferraro ◽  
Alberto Morello ◽  
Sirio Conte ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
New Generation

New-generation devices for transcatheter aortic valve implantation

2018 ◽  
Vol 66 (6) ◽  
Author(s):  
Laura Gatto ◽  
Giuseppe Biondi-Zoccai ◽  
Enrico Romagnoli ◽  
Giacomo Frati ◽  
Francesco Prati ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
New Generation
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