title: Acute Invasive Hemodynamic Effects of Transcatheter Aortic Valve Replacement.
abstract: Aortic stenosis imposes a chronic pressure overload on the left ventricle, with attendant adaptations in hemodynamics, muscle mass and performance. The hemodynamic changes that occur during the initial 24 h following abrupt removal of the impediment to left ventricular outflow have not been previously examined.
  
  
  
  A total of 52 patients with right heart catheterization was evaluated before, within 6 h and at 24 h after successful transcatheter aortic valve replacement (TAVR). Echocardiographic data were examined before and within 30 days of the procedure.
  
  
  
  TAVR was successful in all 52 patients, and at 24 h after the procedure resulted in: (i) an increase in cardiac index (CI) (from 2.0 ± 0.6 to 3.1 ± 0.7 l/min/ m2, p <0.001) and stroke volume (SV) (from 62.3 ± 18.7 to 76.6 ± 21.3 ml, p <0.001); (ii) reductions in systemic vascular resistance (from 1555 ± 458 to 1021 ± 280 dyne·s/cm5, p <0.001) and pulmonary vascular resistance (from 174 ± 150 to 112 ± 76 dyne·s/cm5, p = 0.001); (iii) reductions in pulmonary capillary wedge pressure (from 24.2 ± 6.7 to 19.7 ± 7.3 mmHg, p <0.001), mean pulmonary artery pressure (from 32.2 ± 9.9 to 27.5 ± 8.8 mmHg, p = 0.002) and in central venous pressure (from 13.5 ± 4.8 to 9.4 ± 3.9 mmHg, p <0.001); and (iv) an increase in systolic arterial pressure (from 127 ± 25 to 135 ± 14 mmHg, p = 0.04), along with a decrease in diastolic arterial pressure (from 58 ± 11 to 53 ± 9 mmHg, p = 0.009).
  
  
  
  Successful TAVR results in immediate and sizeable improvements in SV and CI, reductions in left and right ventricular filling pressures, and marked reductions in systemic and pulmonary vascular resistances.
authors.affiliation: Department of Transcatheter Heart Valves, HYGEIA Hospital, Athens.
authors.forename: Michael
authors.initials: M
authors.lastname: Chrissoheris
authors.affiliation: University Cardiology Clinic, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Antonis
authors.initials: A
authors.lastname: Ziakas
authors.affiliation: Department of Transcatheter Heart Valves, HYGEIA Hospital, Athens.
authors.forename: Antonis
authors.initials: A
authors.lastname: Chalapas
authors.affiliation: University Cardiology Clinic, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Chadjimiltiades
authors.affiliation: University Cardiology Clinic, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Styliades
authors.affiliation: University Cardiology Clinic, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Charalambos
authors.initials: C
authors.lastname: Karvounis
authors.affiliation: Department of Transcatheter Heart Valves, HYGEIA Hospital, Athens.
authors.forename: Ioulia
authors.initials: I
authors.lastname: Nikolaou
authors.affiliation: Department of Transcatheter Heart Valves, HYGEIA Hospital, Athens.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Spargias
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D020127:Recovery of Function; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right