The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis

Maximilian Will*, Konstantin Schwarz, Thomas Weiss, Gregor Leibundgut, Elisabeth Schmidt, Paul Vock, Roya Mousavi, Josip a. Borovac, Chun shing Kwok, Uta c. Hoppe, Julia Mascherbauer, Gudrun Lamm

*Corresponding author for this work

Research output: Journal article (peer-reviewed)Journal article

Abstract

Background: Coronary artery disease (CAD) is a common finding in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). However, the impact on prognosis of chronic total occlusions (CTOs), a drastic expression of CAD, remains unclear. Methods and results: We retrospectively reviewed 1,487 consecutive TAVR cases performed at a single tertiary care medical center. Pre-TAVR angiograms were analyzed for the presence of a CTO. At the time of TAVR, 11.2% (n = 167) patients had a CTO. There was no significant association between the presence of a CTO and in-hospital or 30-day mortality. There was also no difference in long-term survival. LV ejection fraction and mean aortic gradients were lower in the CTO group. Conclusions: Our analysis suggests that concomitant CTO lesions in patients undergoing TAVR differ in their risk profile and clinical findings to patients without CTO. CTO lesion per se were not associated with increased mortality, nevertheless CTOs which supply non-viable myocardium in TAVR population were associated with increased risk of death. Additional research is needed to evaluate the prognostic significance of CTO lesions in TAVR patients.

Original languageEnglish
Article number1338253
JournalFrontiers in Cardiovascular Medicine
Volume11
DOIs
Publication statusPublished - 23 Feb 2024

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