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Acute effects of transcatheter aortic valve replacement on central aortic hemodynamics in patients with severe aortic stenosis

Hypertension May 18, 2020

Michail M, Hughes AD, Comella A, et al. - Researchers used aortic reservoir pressure, wave intensity analysis, and indices of aortic function, to determine immediate alterations in invasively measured left ventricular and central aortic pressure following transcatheter aortic valve replacement (TAVR) in patients suffering from severe aortic stenosis. The study sample comprised 54 patients (mean age 83.6 ± 6.2 years, 50.0% female) undergoing TAVR. Post-TAVR rises in systolic, diastolic, mean, and pulse aortic pressures were evident. No change in reservoir pressure and a rise in excess pressure by 47% was noted after TAVR. Increased forward compression wave, backward compression wave and forward expansion wave energies were shown in wave intensity analysis. Findings revealed the link of increased central aortic pressure post-TAVR with increased transmitted power and energy to the proximal aorta with increased excess pressure but unchanged reservoir pressure. A potential mechanism for the improved prognosis related to relative hypertension after TAVR is afforded by these changes.

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