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Tytuł pozycji:

Spontaneous echo contrast, left atrial appendage thrombus and stroke in patients undergoing transcatheter aortic valve implantation.

Tytuł :
Spontaneous echo contrast, left atrial appendage thrombus and stroke in patients undergoing transcatheter aortic valve implantation.
Autorzy :
Linder M; Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.
Voigtländer L
Schneeberger Y
Bhadra OD
Grundmann D
Demal T
Goßling A
Ludwig S
Schaefer A
Waldschmidt L
Schirmer J
Reichenspurner H
Blankenberg S
Schäfer U
Westermann D
Schofer N
Conradi L
Seiffert M
Pokaż więcej
Źródło :
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology [EuroIntervention] 2021 Jan 20; Vol. 16 (13), pp. 1114-1122.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Original Publication: Toulouse : Société Europa édition, c2005-
MeSH Terms :
Atrial Appendage*/diagnostic imaging
Atrial Appendage*/surgery
Atrial Fibrillation*
Brain Ischemia*
Stroke*/epidemiology
Stroke*/etiology
Thrombosis*/diagnostic imaging
Thrombosis*/epidemiology
Transcatheter Aortic Valve Replacement*/adverse effects
Echocardiography, Transesophageal ; Humans ; Risk Factors
Entry Date(s) :
Date Created: 20200901 Date Completed: 20210121 Latest Revision: 20210607
Update Code :
20210607
DOI :
10.4244/EIJ-D-20-00743
PMID :
32863242
Czasopismo naukowe
Aims: The relevance of spontaneous echo contrast (SEC) and left atrial appendage thrombus (LAAT) in patients undergoing transcatheter aortic valve implantation (TAVI) remains unclear. In this study, we aimed to assess the prevalence of SEC and LAAT and evaluate the impact on periprocedural outcome after TAVI.
Methods and Results: A total of 2,549 consecutive patients underwent TAVI between 2008 and 2017. After exclusion of cases with insufficient imaging, concomitant procedures or severe intraprocedural complications, 1,558 cases were analysed. Three groups were defined according to (pre)thrombotic formations - moderate or severe SEC (n=89), LAAT (n=53), and reference (n=1,416). The primary outcome was disabling ischaemic stroke within 24 hours. The prevalence was 4.4% for LAAT and 5.4% for moderate/severe SEC. The primary outcome occurred more frequently in patients with moderate/severe SEC (6.8%) compared to the reference (2.1%) and LAAT (1.9%) groups (p=0.020). SEC was identified as an independent risk factor for the primary outcome (OR 3.54 [95% CI: 1.30-9.61], p=0.013). LAAT was associated with an impaired unadjusted one-year survival (43.4%) compared to the SEC (27.3%) and reference groups (18.7%, p<0.001).
Conclusions: SEC and LAAT were detected in a relevant number of patients undergoing TAVI. SEC may represent an important risk factor for intraprocedural stroke; increased mortality was observed in patients with LAAT.

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