Valvular & structural heart disease
Association Between Coronary Flow and Aortic Stenosis During Transcatheter Aortic Valve Implantation
Authors' conclusion
SFR was found to be associated with the severity of AS and with a greater increase in systolic coronary flow immediately after TAVI.
Study context
- Population
- Consecutive patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) with transoesophageal echocardiography (TEE), November 2020 to February 2022
- Participants
- 25 patients
- Exposure
- AS patients with vs without systolic coronary flow reversal before TAVI
- SFRn = 13
- No SFRn = 12reference
- Outcome
- Relationship between AS severity and SFR, and efficacy of TAVI in improving SFR
Methodological detailsconsecutive patients, intraprocedural TEE
- Consecutive patients
- Intraprocedural TEE
Main finding
As reported in the abstract
AS severity by SFR status before TAVI
| Group | Aortic valve peak velocity | Mean AVPG |
|---|---|---|
| SFR | 451.1 ± 45.9 cm/s | 49.2 ± 14.5 mmHg |
| No SFR | 372.1 ± 52.1 cm/s | 30.3 ± 11.6 mmHg |
Aortic valve peak velocity
SFR451.1 ± 45.9 cm/s
No SFR372.1 ± 52.1 cm/s
Mean AVPG
SFR49.2 ± 14.5 mmHg
No SFR30.3 ± 11.6 mmHg
- SFR vs No SFR: P < 0.001 — aortic valve peak velocity
- SFR vs No SFR: P = 0.002 — mean AVPG
- SFR disappeared immediately after TAVI
- 11 of 13 (84.6%)
Observational data: associations, not effects.
Further findings
Cut-offs associated with SFR before TAVI
- Aortic valve peak velocity >410.0 cm/s
- specificity 75.0%; sensitivity 92.3%
- Mean AVPG >37.4 mmHg
- specificity 83.3%; sensitivity 92.3%
Systolic coronary velocity-time integral (VTI), before vs after TAVI (overall) · immediately after TAVI
- Systolic coronary VTI increased after TAVI (before vs after)
- 2.0 ± 4.7 vs. 6.4 ± 3.2 cm, P < 0.001
- Increase greater in SFR than No SFR
- interaction P = 0.035
Original publication
Association Between Coronary Flow and Aortic Stenosis During Transcatheter Aortic Valve Implantation. ESC Heart Fail. Published 13 April 2023. doi:10.
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