@article{3021682,
    title = "Impact of “high” implantation on functionality of self-expandable bioprosthesis during the short- and long-term outcome of patients who undergo transcatheter aortic valve implantation: Is high implantation beneficial?",
    author = "Vavuranakis, M. and Kariori, M. and Scott, L. and Kalogeras, K. and Siasos, G. and Vrachatis, D. and Lavda, M. and Kalantzis, C. and Vavuranakis, M. and Bei, E. and Moldovan, C.-M. and Oikonomou, E. and Stefanadis, C. and Tousoulis, D.",
    journal = "Cardiovascular Therapeutics",
    year = "2018",
    volume = "36",
    number = "3",
    publisher = "Wiley-Blackwell Publishing Ltd",
    issn = "1755-5914, 1755-5922",
    doi = "10.1111/1755-5922.12330",
    keywords = "aged;  all cause mortality;  aortic regurgitation;  aortography;  Article;  controlled study;  echocardiography;  female;  follow up;  heart hemodynamics;  heart left ventricle;  hospital discharge;  human;  major clinical study;  male;  outcome assessment;  paravalvular aortic regurgitation;  prediction;  priority journal;  self expandable bioprosthesis;  transcatheter aortic valve implantation;  aortic valve;  aortic valve stenosis;  bioprosthesis;  coronary blood vessel;  diagnostic imaging;  heart;  hemodynamics;  procedures;  prosthesis implantation;  reproducibility;  retrospective study;  surgery;  transcatheter aortic valve implantation;  treatment outcome;  very elderly;  x-ray computed tomography, Aged;  Aged, 80 and over;  Aortic Valve;  Aortic Valve Stenosis;  Bioprosthesis;  Coronary Vessels;  Echocardiography;  Female;  Follow-Up Studies;  Heart;  Hemodynamics;  Humans;  Male;  Prosthesis Implantation;  Reproducibility of Results;  Retrospective Studies;  Tomography, X-Ray Computed;  Transcatheter Aortic Valve Replacement;  Treatment Outcome",
    abstract = "Aim: High position of the self-expandable bioprosthesis CoreValve/Evolut R has been proved to affect immediate hemodynamics of the valve. Whether this may have any impact on long-term procedural outcome has not been defined yet. The purpose of this study was to assess whether the final position of aortic bioprosthesis affects its long-term functionality. Method: Consecutive patients (pts) who underwent successful TAVI procedure were evaluated and separated into 2 groups according to the implantation depth (ID): Group I: pts with 4 mm <ID ≤13 mm; Group II: pts with ID ≤4 mm. ID was measured utilizing the final aortography after device delivery and was defined as the distance both from the native non- and left coronary cusp to the deepest edge of the deployed bioprosthesis in the left ventricle. Clinical outcome and echocardiographic parameters were recorded before the procedure, at discharge, at 1-month and 1-year-follow-up. Results: One hundred and ninety-eight pts (80 ± 5.5 years, 107 males [54%]) treated with the CoreValve/Evolut R bioprostheses were recorded. Group I appeared to have higher peak gradient (17 ± 6.5 vs 14 ± 5.5 mm Hg, P =.02) as well as Vmax (2 ± 0.4 vs 1.84 ± 0.38 m/s, P =.02) at follow-up after 1 year when compared with Group II (ID <4 mm). Grouping for ID did not affect all-cause 1-year mortality. Paravalvular aortic regurgitation, as well as LVEF at discharge, proved to be independent predictors of all-cause 1-year mortality when adjusted for cofactors. Conclusion: Implantation depth under 4 mm seems to have a favorable effect on long-term hemodynamic valve functionality. © 2018 John Wiley & Sons Ltd"
}