الفهرس | Only 14 pages are availabe for public view |
Abstract Transcatheter Aortic Valve Implantation (TAVI) has a growing target population after being indicated even in low-surgical-risk patients with severe symptomatic aortic stenosis. However, postoperative short- and long-term outcomes can be compromised due to para-valvular leakage (PVL). A lot of manoeuvres have been investigated to decrease this partially avoidable operational hazard. Oversizing is a main technique to decrease the PVL, despite being itself a risky procedural step. Many studies have been conducted to identify the optimum degree of oversizing. However, studies about oversizing by more than 20% are less frequent. In this study, we were trying to prove the safety and efficacy of oversizing equal to or more than 20%. Avoiding new-onset conduction disturbance, coronary encroachment, annular injury, and decreasing the PVL were our primary end points. Our secondary end point was to find predictors for new-onset conduction disturbance and para-valvular leakage in a specific low-risk population. We initially included 209 patients who underwent TAVI using self-expandable valves. 66 patients were excluded because of the baseline conduction disturbance and lack of sufficient data, so 143 patients, 60 (42.0%) females and 83 (58.0%) males, were enrolled in our study as two groups: group A included 97 patients with an oversizing index (OI) of less than 20%, and group B included 46 patients with an OI of 20% or more. We conducted a new technique for more accurate measuring of the OI in the context of the implantation depth, and our patients were categorized using this technique. The study was done retrospectively for 49 patients and prospectively for the rest of the patients. |