Computed Tomographic Predictors of Conduction Disturbances Following Transcatheter Aortic Valve Implantation

Abdelshafy, Mahmoud; Mustafa, Mansour Mohammad; Shawky, Islam; Abdelhamid, Abdelhamid Ismail; Abdul-Wahab, Sameh Mosaad

doi:10.21608/ijma.2023.217334.1702

	Computed Tomographic Predictors of Conduction Disturbances Following Transcatheter Aortic Valve Implantation
International Journal of Medical Arts
Article 11, Volume 5, Issue 7, July 2023, Page 3465-3469 PDF (944.43 K)
Document Type: Original Article
DOI: 10.21608/ijma.2023.217334.1702
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Authors
Mahmoud Abdelshafy ¹; Mansour Mohammad Mustafa¹; Islam Shawky¹; Abdelhamid Ismail Abdelhamid¹; Sameh Mosaad Abdul-Wahab²
¹Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
²Department of Cardiology, Faculty of Medicine, Modern University of Technology and Information (MTI), Cairo, Egypt
Abstract
Background: It is not uncommon for patients who undergo TAVI to experience conduction abnormalities that require the placement of a new permanent pacemaker [PPM]. However, using a comprehensive multi-slice computed tomography [MSCT] analysis can aid in predicting and planning the procedure for optimal results. Aim of the work: Our objective was to examine the MSCT predictors of conduction disturbances that necessitate PPM after TAVI. Patients and Methods: We enrolled patients who had undergone TAVI with the Evolut platform. A comprehensive MSCT analysis was conducted, which included measuring the length of the membranous septum [MS], semi-quantitative analysis of the aortic leaflets, and assessment of mitral annulus calcification. Results: Among 100 patients [age, 81.8±5.1 years; 32% female, median EuroSCORE II 2.8[1.8, 4.4]], 10[10%] required PPM at discharge. Compared with patients who did not require a new PPM, those who did have shorter membranous septum [MS] length and more frequent ≥moderate mitral annular calcification. Conclusion: The length of the membranous septum and the severity of mitral annular calcification have been determined to be important factors in predicting the need for a permanent pacemaker implantation following transcatheter aortic valve implantation.
Keywords
TAVI; Conduction disturbance; Pacemaker implantation; Computed tomography


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