Aortic valve calcification burden was lower in low-gradient aortic stenosis subtypes than in high-gradient, but calcification severity was not associated with 2-year mortality after TAVI.
Cohort (n=315)
No
Does aortic valve calcification burden differ across severe aortic stenosis subtypes and does it affect 2-year mortality in patients undergoing TAVI?
While low-gradient severe aortic stenosis subtypes have a lower valvular calcification burden than high-gradient AS, this difference does not impact 2-year all-cause mortality following transfemoral TAVI.
Background: The extent and distribution of valvular calcification may differ across hemodynamic subtypes of severe aortic stenosis (AS), but their clinical relevance in patients undergoing transcatheter aortic valve implantation (TAVI) remains incompletely understood. Methods: We retrospectively analyzed 315 consecutive patients undergoing transfemoral TAVI for symptomatic severe AS at a single center between January 2020 and December 2022. Aortic valve calcification was assessed by aortic valve calcium score (AVCS) on non-contrast CT and by calcification volume (CV) on contrast-enhanced CT. Patients were classified as high-gradient aortic stenosis (HGAS), classical low-flow low-gradient aortic stenosis (cLFLGAS), paradoxical low-flow low-gradient aortic stenosis (pLFLGAS), or normal-flow low-gradient aortic stenosis (NFLGAS). Results: HGAS represented 70.8% of the cohort, whereas low-gradient AS subtypes accounted for the remaining cases. Valvular calcification burden was highest in HGAS and consistently lower in all low-gradient phenotypes, particularly in pLFLGAS. The non-coronary cusp was the most heavily calcified cusp across all groups. Neither AVCS nor CV was associated with all-cause mortality up to 2 years after TAVI. Conclusions: Low-gradient AS subtypes exhibit a lower valvular calcification burden than HGAS, but these differences did not translate into differences in 2-year mortality after transfemoral TAVI in this particular cohort.
Zahab et al. (Mon,) conducted a cohort in Symptomatic severe aortic stenosis (n=315). Aortic valve calcification was evaluated on All-cause mortality up to 2 years after TAVI. Aortic valve calcification burden was lower in low-gradient aortic stenosis subtypes than in high-gradient, but calcification severity was not associated with 2-year mortality after TAVI.