Association between aortomitral continuity calcification and conduction disturbances following transcatheter aortic valve implantation with the balloon‐expandable Myval valve

Abstract Background Given the anatomical proximity of the cardiac conduction system, aortomitral continuity calcification (AMCC) may contribute to conduction disturbances (CD) during transcatheter aortic valve implantation (TAVI) due to radial force on the AMCC. This study aimed to investigate the i...

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Main Authors: Serkan Aslan, Aysel Türkvatan, Mehmet Kanyılmaz, Burçin Yılmaz, Dilara Pay, Kadir Sadıkoğlu, Hande Uysal, Gökhan Demirci, Mehmet Altunova, Serkan Kahraman, Mehmet Ertürk
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Language:English
Published: Wiley 2025-08-01
Series:Journal of Arrhythmia
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Online Access:https://doi.org/10.1002/joa3.70140
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author Serkan Aslan
Aysel Türkvatan
Mehmet Kanyılmaz
Burçin Yılmaz
Dilara Pay
Kadir Sadıkoğlu
Hande Uysal
Gökhan Demirci
Mehmet Altunova
Serkan Kahraman
Mehmet Ertürk
author_facet Serkan Aslan
Aysel Türkvatan
Mehmet Kanyılmaz
Burçin Yılmaz
Dilara Pay
Kadir Sadıkoğlu
Hande Uysal
Gökhan Demirci
Mehmet Altunova
Serkan Kahraman
Mehmet Ertürk
author_sort Serkan Aslan
collection DOAJ
description Abstract Background Given the anatomical proximity of the cardiac conduction system, aortomitral continuity calcification (AMCC) may contribute to conduction disturbances (CD) during transcatheter aortic valve implantation (TAVI) due to radial force on the AMCC. This study aimed to investigate the impact of AMCC on new‐onset CD in patients undergoing TAVI with the balloon‐expandable Myval valve. Methods This retrospective study included 160 patients who underwent TAVI. AMCC was assessed using Agatston and calcium volume scores from preprocedural computed tomography (CT). Multivariable logistic regression was used to identify independent predictors of CD. Results High‐grade atrioventricular block (HAVB) occurred in 13.1% of patients, and 17.5% required permanent pacemaker implantation (PPM). Patients with HAVB and PPM exhibited a higher prevalence of AMCC and significantly higher AMCC scores. An AMCC score >180 was an independent predictor of HAVB (OR, 5.58; 95% CI, 1.43–21.70; p = .013) and PPM (OR, 5.39; 95% CI, 1.75–16.55; p = .002). When classified by AMCC proximity type, right fibrous trigone (RFT)‐dominant calcification was a strong independent predictor of HAVB (OR, 9.22; 95% CI, 1.63–51.99; p = .012) and PPM (OR, 7.62; 95% CI, 1.91–30.38; p = .004). Prolonged QRS duration, greater implantation depth, and shorter membranous septum length were also independent predictors. Conclusion AMCC is a strong independent predictor of HAVB and PPM following TAVI, particularly with scores >180 or when AMCC is anatomically close to the RFT. Preprocedural CT‐based assessment of AMCC burden and proximity may improve risk stratification and procedural planning.
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spelling doaj-art-c388909c0b5e4b2da6543cece033a7102025-08-26T10:38:54ZengWileyJournal of Arrhythmia1880-42761883-21482025-08-01414n/an/a10.1002/joa3.70140Association between aortomitral continuity calcification and conduction disturbances following transcatheter aortic valve implantation with the balloon‐expandable Myval valveSerkan Aslan0Aysel Türkvatan1Mehmet Kanyılmaz2Burçin Yılmaz3Dilara Pay4Kadir Sadıkoğlu5Hande Uysal6Gökhan Demirci7Mehmet Altunova8Serkan Kahraman9Mehmet Ertürk10Department of Cardiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyDepartment of Radiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyDepartment of Radiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyDepartment of Radiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyDepartment of Cardiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyDepartment of Cardiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyDepartment of Cardiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyDepartment of Cardiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyDepartment of Cardiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyDepartment of Cardiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyDepartment of Cardiology University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul TurkeyAbstract Background Given the anatomical proximity of the cardiac conduction system, aortomitral continuity calcification (AMCC) may contribute to conduction disturbances (CD) during transcatheter aortic valve implantation (TAVI) due to radial force on the AMCC. This study aimed to investigate the impact of AMCC on new‐onset CD in patients undergoing TAVI with the balloon‐expandable Myval valve. Methods This retrospective study included 160 patients who underwent TAVI. AMCC was assessed using Agatston and calcium volume scores from preprocedural computed tomography (CT). Multivariable logistic regression was used to identify independent predictors of CD. Results High‐grade atrioventricular block (HAVB) occurred in 13.1% of patients, and 17.5% required permanent pacemaker implantation (PPM). Patients with HAVB and PPM exhibited a higher prevalence of AMCC and significantly higher AMCC scores. An AMCC score >180 was an independent predictor of HAVB (OR, 5.58; 95% CI, 1.43–21.70; p = .013) and PPM (OR, 5.39; 95% CI, 1.75–16.55; p = .002). When classified by AMCC proximity type, right fibrous trigone (RFT)‐dominant calcification was a strong independent predictor of HAVB (OR, 9.22; 95% CI, 1.63–51.99; p = .012) and PPM (OR, 7.62; 95% CI, 1.91–30.38; p = .004). Prolonged QRS duration, greater implantation depth, and shorter membranous septum length were also independent predictors. Conclusion AMCC is a strong independent predictor of HAVB and PPM following TAVI, particularly with scores >180 or when AMCC is anatomically close to the RFT. Preprocedural CT‐based assessment of AMCC burden and proximity may improve risk stratification and procedural planning.https://doi.org/10.1002/joa3.70140aortomitral continuitycomputed tomographyconduction disturbancepermanent pacemaker implantationtranscatheter aortic valve implantation
spellingShingle Serkan Aslan
Aysel Türkvatan
Mehmet Kanyılmaz
Burçin Yılmaz
Dilara Pay
Kadir Sadıkoğlu
Hande Uysal
Gökhan Demirci
Mehmet Altunova
Serkan Kahraman
Mehmet Ertürk
Association between aortomitral continuity calcification and conduction disturbances following transcatheter aortic valve implantation with the balloon‐expandable Myval valve
Journal of Arrhythmia
aortomitral continuity
computed tomography
conduction disturbance
permanent pacemaker implantation
transcatheter aortic valve implantation
title Association between aortomitral continuity calcification and conduction disturbances following transcatheter aortic valve implantation with the balloon‐expandable Myval valve
title_full Association between aortomitral continuity calcification and conduction disturbances following transcatheter aortic valve implantation with the balloon‐expandable Myval valve
title_fullStr Association between aortomitral continuity calcification and conduction disturbances following transcatheter aortic valve implantation with the balloon‐expandable Myval valve
title_full_unstemmed Association between aortomitral continuity calcification and conduction disturbances following transcatheter aortic valve implantation with the balloon‐expandable Myval valve
title_short Association between aortomitral continuity calcification and conduction disturbances following transcatheter aortic valve implantation with the balloon‐expandable Myval valve
title_sort association between aortomitral continuity calcification and conduction disturbances following transcatheter aortic valve implantation with the balloon expandable myval valve
topic aortomitral continuity
computed tomography
conduction disturbance
permanent pacemaker implantation
transcatheter aortic valve implantation
url https://doi.org/10.1002/joa3.70140
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