PMID- 35935663 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220809 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 9 DP - 2022 TI - Valve embolization during transcatheter aortic valve implantation: Incidence, risk factors and follow-up by computed tomography. PG - 928740 LID - 10.3389/fcvm.2022.928740 [doi] LID - 928740 AB - BACKGROUND: In most cases of transcatheter valve embolization and migration (TVEM), the embolized valve remains in the aorta after implantation of a second valve into the aortic root. There is little data on potential late complications such as valve thrombosis or aortic wall alterations by embolized valves. AIMS: The aim of this study was to analyze the incidence of TVEM in a large cohort of patients undergoing transcatheter aortic valve implantation (TAVI) and to examine embolized valves by computed tomography (CT) late after TAVI. METHODS: The patient database of our center was screened for cases of TVEM between July 2009 and July 2021. To identify risk factors, TVEM cases were compared to a cohort of 200 consecutive TAVI cases. Out of 35 surviving TVEM patients, ten patients underwent follow-up by echocardiography and CT. RESULTS: 54 TVEM occurred in 3757 TAVI procedures, 46 cases were managed percutaneously. Horizontal aorta (odds ratio [OR] 7.51, 95% confidence interval [CI] 3.4-16.6, p < 0.001), implantation of a self-expanding valve (OR 4.63, 95% CI 2.2-9.7, p < 0.01) and a left ventricular ejection fraction < 40% (OR 2.94, 95% CI 1.1-7.3, p = 0.016) were identified as risk factors for TVEM. CT scans were performed on average 26.3 months after TAVI (range 2-84 months) and detected hypoattenuated leaflet thickening (HALT) in two patients as well as parts of the stent frame protruding into the aortic wall in three patients. CONCLUSION: TVEM represents a rare complication of TAVI. Follow up-CT detected no pathological findings requiring intervention. CI - Copyright (c) 2022 Frumkin, Pietron, Kind, Brand, Knebel, Laule, Leistner, Landmesser, Krackhardt, Sherif, Sundermann, Grubitzsch, Lembcke, Niehues, Stangl and Dreger. FAU - Frumkin, David AU - Frumkin D AD - Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. FAU - Pietron, Malte AU - Pietron M AD - Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Kind, Andreas AU - Kind A AD - Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Brand, Anna AU - Brand A AD - Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. AD - Medizinische Klinik fur Kardiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Knebel, Fabian AU - Knebel F AD - Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. AD - Sana Klinikum Lichtenberg, Berlin, Germany. FAU - Laule, Michael AU - Laule M AD - Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Leistner, David M AU - Leistner DM AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. AD - Medizinische Klinik fur Kardiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Landmesser, Ulf AU - Landmesser U AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. AD - Medizinische Klinik fur Kardiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Krackhardt, Florian AU - Krackhardt F AD - Medizinische Klinik mit Schwerpunkt Kardiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Sherif, Mohammad AU - Sherif M AD - Medizinische Klinik mit Schwerpunkt Kardiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Sundermann, Simon H AU - Sundermann SH AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. AD - Klinik fur kardiovaskulare Chirurgie, Charite - Universitatsmedizin Berlin, Berlin, Germany. AD - Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany. FAU - Grubitzsch, Herko AU - Grubitzsch H AD - Klinik fur kardiovaskulare Chirurgie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Lembcke, Alexander AU - Lembcke A AD - Klinik fur Radiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Niehues, Stefan M AU - Niehues SM AD - Klinik fur Radiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Stangl, Karl AU - Stangl K AD - Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. FAU - Dreger, Henryk AU - Dreger H AD - Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charite - Universitatsmedizin Berlin, Berlin, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. LA - eng PT - Journal Article DEP - 20220722 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC9355668 OTO - NOTNLM OT - complications OT - transcatheter aortic valve replacement OT - valve dislocation OT - valve embolization OT - valve migration COIS- HD, KS, ML, DL, UL, and MS were received financial research support and speakers' fees from Abbott, Edwards LifeSciences and Medtronic. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/08/09 06:00 MHDA- 2022/08/09 06:01 PMCR- 2022/01/01 CRDT- 2022/08/08 03:35 PHST- 2022/04/26 00:00 [received] PHST- 2022/07/04 00:00 [accepted] PHST- 2022/08/08 03:35 [entrez] PHST- 2022/08/09 06:00 [pubmed] PHST- 2022/08/09 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2022.928740 [doi] PST - epublish SO - Front Cardiovasc Med. 2022 Jul 22;9:928740. doi: 10.3389/fcvm.2022.928740. eCollection 2022.