Abstract
ABSTRACTObjectiveTranscatheter aortic valve replacement (TAVR) is a cine-fluoroscopic guided procedure. The amount of radiation used during the procedure is strictly related with fluoroscopy time (FT) that has been demonstrated to be associated with outcomes and complexity of procedure in percutaneous coronary interventions. The aim of our study is to demonstrate the relationship between FT and short-term outcomes after TAVR.MethodsAfter splitting 1797 consecutive patients according to tertiles of FT, the composite endpoint early safety (ES) was adjudicated according to Valve Academic Research Consortium (VARC)-2 and -3 consensus documents and the composite endpoints of device success (DS) and technical success (TS) according to VARC-3 criteria.ResultsThe absence of all outcomes (TS, DS, and ES according to VARC-3 and ES according to VARC-2) was significantly associated with higher FT and this association persisted after propensity score matching analysis. Notwithstanding, after receiver operating characteristic analysis, only the FT cut-offs identified for VARC-3 TS and VARC-2 ES had adequate diagnostic accuracy in identifying the absence of these endpoints.ConclusionsLonger FT is related with peri-procedural and short-term outcomes after the procedure, especially in those that are more complex. A FT duration of more than 30 minutes has an adequate accuracy in identifying VARC-3 technical failure and absence of VARC-2 ES.What is already known on this topicFT is related with complexity and outcomes in PCI. No data is available about FT and TAVR.What this study addsFT >30 minutes has an adequate accuracy in identifying VARC-3 technical failure and absence of VARC-2 ES.How this study might affect research, practice or policyFT that lasts more than 30 minutes in TAVR is linked independently to short-term adverse outcomes after TAVR. A strict follow-up is needed in this procedural setting as FT is a new independent predictor of adverse outcome after TAVR.
Publisher
Cold Spring Harbor Laboratory