Maeno Y, et al. – This study investigated the impact of left ventricular outflow tract (LVOT) calcium on two–year mortality following transcatheter aortic valve implantation (TAVI). Post–TAVI, survival probability was lower in patients with ≥moderate LVOT calcium versus those with ≤ mild LVOT calcium, as demonstrated in mid–term follow up. Patients with high grade LVOT calcium should be monitored with longer term follow–ups after TAVI.

Methods

• This study included a total of 537 consecutive patients who underwent TAVI and divided into two groups, stratified based on the severity of LVOT calcium.
• Primary outcome was 2-year overall survival.

Results

• Data reported that the ≥moderate LVOT calcium group included 107 patients (19.9%) and the remaining 430 patients (80.1%) were included in the ≤mild LVOT calcium group.
• Researchers observed that after a median follow up of 717 days (interquartile range 484 – 828), the 2-year overall survival probability was significantly lower in the ≥ moderate LVOT calcium group than the ≤ mild LVOT calcium group (log-rank p=0.001), as revealed by the Kaplan-Meier analysis.
• Findings also indicated that, on a Cox hazard model, ≥moderate LVOT calcium was associated with increased all-cause mortality after TAVI (hazard ratio 1.74; p = 0.009).
• Additionally, upon sub-group analysis, based on valve designs, it was noted that SAPIEN 3-TAVI done in the setting of ≥moderate LVOT calcium had relatively similar survival probability as those of ≤ mild LVOT-CA (log-rank p=0.18), which is in contrast to older generation valves (log-rank p=0.001).