CBS 2019
CBSMD教育中心
中 文

Transcatheter Aortic Valve Replacement

Abstract

Recommended Article

The Utility of Rapid Atrial Pacing Immediately Post-TAVR to Predict the Need for Pacemaker Implantation von Willebrand Factor and Management of Heart Valve Disease: JACC Review Topic of the Week Frailty and Bleeding in Older Adults Undergoing TAVR or SAVR: Insights From the FRAILTY-AVR Study Leaflet immobility and thrombosis in transcatheter aortic valve replacement Left Ventricular Hypertrophy and Clinical Outcomes Over 5 Years After TAVR: An Analysis of the PARTNER Trials and Registries Balloon Aortic Valvuloplasty as a Bridge to Aortic Valve Replacement: A Contemporary Nationwide Perspective 5-Year Outcomes After TAVR With Balloon-Expandable Versus Self-Expanding Valves: Results From the CHOICE Randomized Clinical Trial Frailty in Older Adults Undergoing Aortic Valve Replacement: The FRAILTY-AVR Study
|<<... 11 12 13 14 15 16 17 18 >>|

Original ResearchVolume 74, Issue 15, October 2019

JOURNAL：J Am Coll Cardiol. Article Link

Ascending Aortic Length and Risk of Aortic Adverse Events: The Neglected Dimension

J Wu, MA Zafar, YP Li, JA Elefteriades et al. Keywords: aortic adverse events; aortic aneurysm; aortic dimensions; aortic elongation; natural history; thoracic aortic aneurysm

ABSTRACT

BACKGROUND - Little information is available regarding the longitudinal changes of the aneurysmal ascending aorta.

OBJECTIVES - This study sought to outline the natural history of ascending thoracic aortic aneurysm (ATAA) based on ascending aortic length (AAL) and develop novel predictive tools to better aid risk stratification.

METHODS - The ascending aortic diameters and lengths, and long-term aortic adverse events (AAEs) (rupture, dissection, and death) of 522 ATAA patients were evaluated using comprehensive statistical approaches.

RESULTS - An AAL of ≥13 cm was associated with an almost 5-fold higher average yearly rate of AAEs compared with an AAL of <9 cm. Two AAL “hinge points” with a sharp increase in the estimated probability of AAEs were detected between 11.5 and 12.0 cm, and between 12.5 and 13.0 cm. The mean estimated annual aortic elongation rate was 0.18 cm/year, and aortic elongation was age dependent. Aortic diameter increased 18% due to dissection while AAL only increased by 2.7%. There was a noticeable improvement in the discrimination of the logistic regression model (area under the receiver-operating characteristic curve: 0.810) due to the introduction of aortic height index (AHI) (diameter height index + length height index). The AHIs <9.33, 9.38 to 10.81, 10.86 to 12.50, and ≥12.57 cm/m were associated with a ∼4%, ∼7%, ∼12%, and ∼18% average yearly risk of AAEs, respectively.

CONCLUSIONS - An aortic elongation of 11 cm serves as a potential intervention criterion for ATAA, which is even more reliable than diameter due to its relative immunity to dissection. AHI (including both length and diameter) is more powerful than any single parameter in this study.

>CBS CBS 2019

> CBS 2019 REGISTRATION

> CBS 2019 PROGRAM

> CBS 2019 CALL FOR SCIENCE

> CBS 2019 SPOTLIGHTS

 CBSMD

> CBSMD WEBSITE REGISTRATION

> EDUCATION CENTER

> RECOMMANDED PAPER

> TOP 10 RESEARCH PAPER

> PRE-READING

CBS 2019 CBS 2019 FACULTY Education Resource CBSMD Scientific Library
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top