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<p>Significant fibrosis is characteristic of rheumatic aortic valve disease that affects anchoring and deployment of the trans-catheter heart valve. Our goal was to determine whether trans-catheter aortic valve implantation (TAVI) is an effective treatment option for severe aortic stenosis patients with rheumatic valvular disease. This study is a prospective cohort study that includes a total of 54 rheumatic severe aortic stenosis patients who were referred for TAVI. The age ranged from 65.00 to 83.00&#xa0;years (mean age 72.75 ± 5.86&#xa0;years). Notably, 63% of the patients had undergone preimplantation balloon dilatation. The outcomes included total new conduction disturbances (transient and permanent defects of atrio-ventricular block and left bundle branch block) in 31.4% of the patients, permanent pacemaker implantation in 3.7%, and valve embolization in 1.85%, and no patients had moderate to severe para-valvular leak. All-cause death within a 6-month follow-up was 3.7%. This cohort was then compared to a propensity score matched group of degenerative calcific severe aortic stenosis of 54 cases revealing comparable post-procedural results. Compared with the outcomes of TAVI in patients with degenerative aortic stenosis, TAVI represents a viable and durable option for rheumatic severe aortic stenosis patients.</p> Graphical abstract <p></p>

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Transcatheter aortic valve implantation in elderly patients with severe aortic stenosis and rheumatic phenotype

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月31日

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  • Ahmed Abdelrahman Elkaialy,
  • Nabil Farag,
  • Ahmad Elsayed Mostafa,
  • Mahmoud Baraka,
  • Diaa Kamal

摘要

Significant fibrosis is characteristic of rheumatic aortic valve disease that affects anchoring and deployment of the trans-catheter heart valve. Our goal was to determine whether trans-catheter aortic valve implantation (TAVI) is an effective treatment option for severe aortic stenosis patients with rheumatic valvular disease. This study is a prospective cohort study that includes a total of 54 rheumatic severe aortic stenosis patients who were referred for TAVI. The age ranged from 65.00 to 83.00 years (mean age 72.75 ± 5.86 years). Notably, 63% of the patients had undergone preimplantation balloon dilatation. The outcomes included total new conduction disturbances (transient and permanent defects of atrio-ventricular block and left bundle branch block) in 31.4% of the patients, permanent pacemaker implantation in 3.7%, and valve embolization in 1.85%, and no patients had moderate to severe para-valvular leak. All-cause death within a 6-month follow-up was 3.7%. This cohort was then compared to a propensity score matched group of degenerative calcific severe aortic stenosis of 54 cases revealing comparable post-procedural results. Compared with the outcomes of TAVI in patients with degenerative aortic stenosis, TAVI represents a viable and durable option for rheumatic severe aortic stenosis patients.

Graphical abstract