Background: Periprocedural stroke during transcatheter aortic valve implantation is a rare but devastating complication. The calcified aortic valve is the most likely source of the emboli in a periprocedural stroke. The total load and distribution of calcium in the leaflets, aortic root, and left ventricular outflow tract varies from patient to patient. Consequently, there could be patterns of calcification that are associated with a higher risk of stroke. This study aimed to explore whether the pattern of calcification in the left ventricular outflow tract, annulus, aortic valve, and ascending aorta can be used to predict a periprocedural stroke. Methods: Among the 3282 consecutive patients who received a transcatheter aortic valve implantation in the native valve in Sweden from 2014 to 2018, we identified 52 who had a periprocedural stroke. From the same cohort, a control group of 52 patients was constructed by propensity score matching. Both groups had one missing cardiac computed tomography, and 51 stroke and 51 control patients were blindly reviewed by an experienced radiologist. Results: The groups were well balanced in terms of demographics and procedural data. Of the 39 metrics created to describe calcium pattern, only one differed between the groups. The length of calcium protruding above the annulus was 10.6 mm (interquartile range 7-13.6) for patients without stroke and 8 mm (interquartile range 3-10) for stroke patients. Conclusions: This study could not find any pattern of calcification that predisposes for a periprocedural stroke.
Fagman, ErikaUniversity of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Sahlgrenska Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Sahlgrens Univ Hosp, Dept Radiol, Gothenburg, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Sahlgrenska Inst Clin Sci, Gothenburg, Sweden.(Swepub:gu)xfagme
(författare)
Samano, Ninos,1972-Örebro University,Region Örebro län,Örebro universitet, Institutionen för medicinska vetenskaper,Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden,Örebro Univ, Univ Hlth Care Res Ctr, Fac Med & Hlth, Örebro, Sweden.(Swepub:oru)nso
(författare)
Settergren, M.Karolinska Institutet,Karolinska Univ Hosp, Dept Cardiol, Stockholm, Sweden.;Karolinska Inst, Stockholm, Sweden.
(författare)
Götberg, MatthiasLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Clin Sci Lund, Cardiol, Lund, Sweden.(Swepub:lu)kard-mgo
(författare)
Pistea, AdrianLund University,Lunds universitet,Kardiovaskulär forskning - immunitet och ateroskleros,Forskargrupper vid Lunds universitet,Cardiovascular Research - Immunity and Atherosclerosis,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Radiol, Lund, Sweden.(Swepub:lu)med-adp
(författare)
Skonsammare hjärtkirurgiForskargrupper vid Lunds universitet
(creator_code:org_t)
Sammanhörande titlar
Ingår i:Structural Heart-the Journal of the Heart Team: Elsevier BV6:42474-87062474-8714