TY - JOUR JO - EuroIntervention TI - Hemodynamic structural valve deterioration following transcatheter aortic valve implantation with latest-generation balloon-expandable valves AB - <span class="abstracts-titres">Aims:</span>&nbsp;Elevated gradients have been proposed to be associated with hemodynamic structural valve deterioration (SVD) after transcatheter aortic valve implantation (TAVI) and data regarding their characterization remain scarce.&nbsp;<br /><br /><span class="abstracts-titres">Methods and results:</span>&nbsp;691 patients undergoing transfemoral TAVI were enrolled. The primary endpoint was moderate or severe hemodynamic SVD during 12-month follow-up after TAVI, defined as (I) mean transvalvular gradient &ge;20 mmHg or (II) mean transvalvular gradient change &ge;10 mmHg. The primary endpoint was observed in 10.3% after TAVI. Use of 20mm valve, valve-in-valve procedure and oral anticoagulation (OAC) were independently associated with hemodynamic SVD, whereas valve-in-valve procedure and OAC were the only significant variables after accounting for death as a competing event. OAC was significantly associated with both, hemodynamic SVD (RR 8.65; p=0.004) and death (RR 3.57; p=0.06), whereas valve-in-valve procedure was only associated with hemodynamic SVD (RR 52.76; p&lt;0.001). Valve thrombosis was present in 0.87% (6/691) of all patients.&nbsp;<br /><br /><span class="abstracts-titres">Conclusions:</span> &nbsp;The prevalence of moderate or greater hemodynamic SVD during the first 12 months after TAVI is 10.3%. Procedural factors and pharmacotherapy seem to play a key role during manifestation. Future studies should focus on the underlying mechanisms. AU - Rheude Tobias AU - Pellegrini Costanza AU - Cassese Salvatore AU - Wiebe Jens AU - Wagner Sophia AU - Trenkwalder Teresa AU - Alvarez Hector AU - Mayr Patrick AU - Hengstenberg Christian AU - Schunkert Heribert AU - Kastrati Adnan AU - Husser Oliver AU - Joner Michael VL - IS - Y1 - 10/09/2019 Y1 - 2019 DOI - 10.4244/EIJ-D-19-00710 SP - KW - aortic stenosis KW - non-invasive imaging KW - tavi PB - Europa Digital & Publishing UR - https://eurointervention.pcronline.com/article/hemodynamic-structural-valve-deterioration-following-transcatheter-aortic-valve-implantation-with-latest-generation-balloon-expandable-valves SN - 1774-024X ER -