title: Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world.
abstract: OBJECTIVE
  Coronary obstruction (CO) is a rare but serious complication of transcatheter aortic valve implantation (TAVI). There are very limited data regarding CO following TAVI. The aim of this study was to evaluate the incidence and outcomes of CO after TAVI and identify the predictors including the valve type.
  
  
  METHODS
  Between October 2006 and March 2015, 1,203 TAVI cases were performed in our institution. Of them, 814 cases whose coronary height was measured using computed tomography for screening were analyzed in this study.
  
  
  RESULTS
  The Edwards SAPIEN/SAPIEN XT (S/XT) was used in 427 (52.4%) cases, the CoreValve in 265 (32.6%), and the S3 in 122 (15.0%). CO occurred in 8 (1.0%) cases, 1.6% with S/XT, 0.4% with CoreValve, and 0% with S3. All instances of CO occurred at the left coronary artery. The 30-day mortality was significantly higher in cases of CO (37.5% vs. 5.8%, P = 0.010). The frequency of CO tended to be lower in recipients of the CoreValve (0.4%) and S3 (0%) compared with the S/XT (1.6%) (P = 0.188 for CoreValve vs. S/XT, P = 0.022 for S3 vs. S/XT).
  
  
  CONCLUSIONS
  CO has poor outcomes and identification of patients at risk of CO to take preventive measures is crucial. The preliminary data showing that the occurrence of CO is low in patients receiving the S3 despite increased prosthesis height need further confirmation. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Takahide
authors.identifier: http://orcid.org/0000-0003-1584-8840
authors.initials: T
authors.lastname: Arai
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lefèvre
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hovasse
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Garot
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Hakim
authors.initials: H
authors.lastname: Benamer
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Unterseeh
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Andrew K
authors.identifier: http://orcid.org/0000-0001-5677-1048
authors.initials: AK
authors.lastname: Roy
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Mauro
authors.initials: M
authors.lastname: Romano
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.|Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hayashida
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.|Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Erik
authors.initials: E
authors.lastname: Bouvier
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Morice
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000401:mortality; D016208:Databases, Factual; D005260:Female; D005602:France / Q000453:epidemiology; D006350:Heart Valve Prosthesis; D006801:Humans; D015994:Incidence; D008297:Male; D000074286:Preliminary Data; D011474:Prosthesis Design; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D016896:Treatment Outcome
keywords: coronary obstruction; severe symptomatic aortic stenosis; transcatheter aortic valve implantation