Cardiology Letters 2022, 31(4):213-220

Comparison of right ventricular function in patients undergoing transcatheter aortic valve implantation and surgical aortic valve replacement

Poliacikova P¹, Hrinova M², Hudec M¹, Belicova M³

¹ Department of Acute Cardiology, Middle Slovak Institute of Cardiovascular Diseases, Banska Bystrica

² Department of Functional Diagnosis, Middle Slovak Institute of Cardiovascular Diseases, Banska Bystrica

³ Internal Clinic JLF UK, Martin, Slovak Republic

Aim: Comparison of the impact of surgical and transcatheter aortic valve replacement on the right ventricular function in patients with severe aortic stenosis.

Methods and results: We performed a prospective analysis of right ventricular function parameters (TAPSE, RVPSV and FAC) of 50 TAVI and 50 AVR patients at three time intervals - preoperatively, up to 7 days and after 6 months postoperatively. Although the patients undergoing AVR were younger and had less complex cardiac impairment, their right ventricular function deteriorated significantly in the early post-operative phase (TAPSE -10.52mm, RVPSV -4.23cm / s, FAC -10.22%, p <0.001) and the right ventricular dysfunction was still present after 6 months in 35.9% of patients. In the more complex TAVI cohort, RV function remained unchanged in the early phase (TAPSE -0.04mm, RVPSV +0.58 cm/s, FAC +0.96%; p = 0.94, p = 0.07, p = 0.43, respectively), and at 6 months follow-up (RVD in 35% at 6m vs 38% at baseline, p = 0.73). The difference in the postoperative behaviour of right ventricular function was statistically significant and consistent after accounting for the preprocedural difference between the cohorts.

Conclusion: Although patients undergoing TAVI have more complex cardiac impairment, TAVI, unlike AVR, does not cause periprocedural deterioration of RV function.

Keywords: aortic stenosis; transcatheter aortic valve replacement; right ventricular dysfunction; risk prediction

Published: April 1, 2022  Show citation