Table 1.
Baseline and procedural characteristics of patients who did and did not develop procedural HAVB/CHB
| All |
Procedural HAVB/CHB |
p value | ||
|---|---|---|---|---|
| (N = 261) | No (n = 205) | Yes (n = 56) | ||
| Age, y | 81.0 (76.0-86.0) | 81.0 (76.0-85.0) | 84 (77.5-88.0) | 0.086 |
| Female | 73 (28.0) | 52 (25.4) | 21 (37.5) | 0.092 |
| Caucasian | 251 (96.2) | 197 (96.1) | 54 (96.4) | 1.00 |
| Body mass index, kg/m2 | 29.1 (25.4-33.3) | 29.4 (25.4-33.6) | 27.5 (25.4-32.7) | 0.36 |
| STS risk score, % | 5.14 (3.50-8.06) | 4.62 (3.32-7.97) | 5.85 (4.35-10.84) | 0.006 |
| Prior CABG | 83 (31.8) | 69 (33.7) | 14 (25.0) | 0.26 |
| Prior myocardial infarction | 63 (24.1) | 47 (22.9) | 16 (28.6) | 0.38 |
| ESRD on dialysis | 12 (4.6) | 7 (3.4) | 5 (8.9) | 0.14 |
| Chronic lung disease | 132 (50.6) | 101 (49.3) | 31 (55.4) | 0.45 |
| History of syncope | 18 (6.9) | 13 (6.3) | 5 (8.9) | 0.55 |
| History of atrial fibrillation/flutter | 101 (38.7) | 74 (36.1) | 27 (48.2) | 0.12 |
| NYHA functional class III or IV | 210 (80.5) | 163 (79.5) | 47 (83.9) | 0.57 |
| LVEF, % | 59 (54-63) | 59 (55-64) | 56 (50-63) | 0.074 |
| Aortic valve area, cm2 | 0.71 (0.58-0.84) [N = 245] | 0.72 (0.61-0.85) [n = 189] | 0.64 (0.52-0.79) [n = 56] | 0.007 |
| Aortic valve mean gradient, mmHg | 41 (34-52) | 41 (34-51) | 46 (35.5-56) | 0.30 |
| Aortic valve peak gradient, mmHg | 70 (58-86) | 70 (58-85) | 71 (58-89) | 0.71 |
| Bicuspid aortic valve | 14 (5.4) | 10 (4.9) | 4 (7.1) | 0.51 |
| Failed bioprosthetic valve | 18 (6.9) | 17 (8.3) | 1 (1.8) | 0.13 |
| Moderate or severe AR | 48 (18.4) | 39 (19.0) | 9 (16.1) | 0.70 |
| Data on aortic annulus∗ | [N = 253] | [n = 197] | [n = 56] | |
| Maximum annular diameter, mm | 28 (26-30) | 28 (26-30) | 28 (26-30.5) | 0.85 |
| Minimum annular diameter, mm | 23 (21-25) | 23 (21-24.9) | 22.5 (20.5-25) | 0.62 |
| Eccentricity index | 0.18 (0.14-0.23) | 0.18 (0.14-0.23) | 0.19 (0.15-0.25) | 0.28 |
| Annular area, mm2 | 493 (416-560) | 500 (420-560) | 476 (411-560) | 0.67 |
| Calcium score of aortic valve leaflets, HU† | 2118 (1310-3261) [N = 197] | 2168 (1321-3240) [n = 149] | 2051 (1263-3345) [n = 48] | 0.80 |
| LVOT calcification‡ | 135/241 (56.0) | 98/186 (52.7) | 37/55 (67.3) | 0.064 |
| Pre-TAVI baseline ECG findings | ||||
| Rhythm | 0.87 | |||
| Sinus rhythm | 218 (83.5) | 173 (84.4) | 45 (80.4) | |
| Atrial fibrillation | 35 (13.4) | 26 (12.7) | 9 (16.1) | |
| Atrial flutter | 5 (1.9) | 4 (2.0) | 1 (1.8) | |
| Junctional rhythm | 3 (1.1) | 2 (1.0) | 1 (1.8) | |
| PR interval, ms | 190 (170-220) [N = 220] | 190 (168-219) [n = 175] | 190 (172-226) [n = 45] | 0.56 |
| QRS duration, ms | 146 (136-156) | 146 (136-156) | 145 (137-153) | 0.72 |
| First degree AVB | 87 (33.3) | 68 (33.2) | 19 (33.9) | 1.00 |
| QRS duration ≥150 ms | 109 (41.8) | 87 (42.4) | 22 (39.3) | 0.76 |
| Left anterior fascicular block | 70 (26.8) | 57 (27.8) | 13 (23.2) | 0.61 |
| Left posterior fascicular block | 3 (1.1) | 3 (1.5) | 0 (0.0) | 1.00 |
| Bifascicular block | 73 (28.0) | 60 (29.3) | 13 (23.2) | 0.41 |
| Trifascicular block | 24 (9.2) | 19 (9.3) | 5 (8.9) | 1.00 |
| Procedural details | ||||
| Nonelective procedure | 12 (4.6) | 10 (4.9) | 2 (3.6) | 1.00 |
| Nonfemoral approach | 17 (6.5) | 12 (5.9) | 5 (8.9) | 0.37 |
| Anesthesia type | 0.24 | |||
| Conscious sedation | 215 (82.4) | 172 (83.9) | 43 (76.8) | |
| General anesthesia | 46 (17.6) | 33 (16.1) | 13 (23.2) | |
| Valve type | 0.49 | |||
| Balloon-expandable | 248 (95.0) | 196 (95.6) | 52 (92.9) | |
| Self-expanding | 13 (5.0) | 9 (4.4) | 4 (7.1) | |
| Valve size | 0.38 | |||
| ≤23 mm | 73 (28.0) | 55 (26.8) | 18 (32.1) | |
| 26 mm | 100 (38.3) | 83 (40.5) | 17 (30.4) | |
| ≥29 mm | 88 (33.7) | 67 (32.7) | 21 (37.5) | |
| Predilation | 62 (23.8) | 44 (21.5) | 18 (32.1) | 0.11 |
| Postdilation | 118 (45.2) | 91 (44.4) | 27 (48.2) | 0.65 |
| Oversizing, % | 5.0 (0.8-8.6) [N = 253] | 4.8 (0.9-8.6) [n = 197] | 5.7 (0.5-9.7) [n = 56] | 0.40 |
| Implantation depth relative to the NCC, mm§ | 2.3 (1.0-4.0) [N = 259] | 2.0 (0.9-3.6) [n = 204] | 3.1 (1.6-5.0) [n = 55] | <0.001 |
Notes. Values are n (%), n/total n (%), or median (interquartile range).
AR = aortic regurgitation, AV = aortic valve, AVB = atrioventricular block, CABG = coronary artery bypass grafting, CHB = complete heart block, CT = computed tomography, ECG = electrocardiogram, ESRD = end-stage renal disease, HAVB = high-degree atrioventricular block, HU = Hounsfield unit, LVEF = left ventricular ejection fraction, LVOT = left ventricular outflow tract, NCC = noncoronary cusp, NYHA = New York Heart Association, STS = Society of Thoracic Surgeons, TAVI = transcatheter aortic valve implantation.
Data on aortic annulus were unavailable in 8 patients because neither contrast CT images nor cardiac magnetic resonance images were performed.
The calcium score of aortic valve leaflets was unavailable in 64 patients owing to a lack of contrast CT images before TAVI or a prior bioprosthetic valve.
Data on LVOT calcification were unavailable in 20 patients owing to a lack of appropriate CT images before TAVI or a prior bioprosthetic valve.
Implantation depth was unavailable in 2 patients owing to a lack of an appropriate fluoroscopy image.