Factors associated with severe conduction injury after domestic self-expanding transcatheter aortic valve replacement:analysis of 84 cases
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(1. Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing 100853, China;2. School of Medicine, Nankai University, Tianjin 300071, China;3. Chinese PLA Medical School, Beijing 100853, China)

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R542.5+2

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    Abstract:

    Objective To analyze the factors associated with severe conduction injury after transcatheter aortic valve implantation (TAVR) with domestic self-expanding valves and assess their predictive efficacy. Methods A retrospective trial was conducted on the patients undergoing TAVR with domestic self-expanding aortic valves in the First Medical Center of Chinese PLA General Hospital from December 2016 to October 2022. According to their postoperative outcomes, they were divided into normal and conduction injury groups. Logistic regression analysis was used to screen the relevant factors. Receiver operating characteristic (ROC) curve was plotted to calculate their predicted efficacy and evaluate the difference in efficacy. SPSS statistics 26.0 was used for statistical analysis. Data comparison between two groups was performed using student′s t test, U test or Chi-square test depending on data type. Results There were 84 patients being enrolled, including 60 patients in the normal group and 24 patients in the conduction injury group. Significant differences were observed in following indicators between the two groups (P=0.005), including left ventricular outflow tract (LVOT) area, LVOT area/annular area, septal length, and difference between septal length and implantation depth (membranous septum minus implantation depth, ΔMSID). Multivariate logistic regression analysis showed that LVOT area/annular area (OR=0.874,95%CI 0.797-0.959, P=0.004) and ΔMSID (OR=0.660,95%CI 0.515-0.846, P=0.001) were independent risk factors for severe conduction injury after TAVR. ROC curve analysis indicated that the area under the curve of LVOT area/annular area and ΔMSID was 0.792 and 0.768, respectively, and was 0.908 for their combination. DeLong test revealed that statistical significance was seen in the predictive efficacy of the single indicator vs their combination (P<0.05). Conclusion LVOT area/annular area and ΔMSID are independent risk factors for incidence of severe conduction injury after TAVR, and can be used to predict the occurrence of new conduction injury after surgery. The two indicators combination shows better predictive efficacy than the single one.

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History
  • Received:December 13,2022
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  • Online: August 22,2023
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