European heart journal. Cardiovascular Imaging · 2026
Anatomical variations in permanent pacemaker requirement after TAVI in bicuspid anatomy.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Yin Yue, Zhao Zhengang, Qiao Xuechen, Yan Mengyun, Jia Yuheng, Li Weiya, Zhang Ying, Wang Yan, Chai Zheng, Tang Yu, Wang Shuoding, Pu Xingzhou, Peng Shiqin, Ran Junpeng, Zhou Jing, Tang Ruisi, Feng Yuan, Chen Mao
Аннотация
AIMS: We sought to illustrate the varying risk of permanent pacemaker implantation (PPMI) following self-expanding TAVI among bicuspid aortic valve (BAV) subtypes, and to categorize BAV anatomical variations based on the risk of PPMI.
METHODS AND RESULTS: We retrospectively analyzed 300 BAV patients with severe aortic stenosis who underwent self-expanding TAVI. Based on leaflet morphology and calcification severity at the commissure between right coronary cusp (RCC) and non-coronary cusp (NCC), BAVs were classified into two subtypes: BAV with MS below commissure (BAV-MSBC) and BAV with MS below leaflet (BAV-MSBL). Univariate and multivariate logistic regressions were performed to identify potential risk factors of PPMI. PPMI rate differed significantly between BAV-MSBC and BAV-MSBL [32.8% (42 of 128) vs. 5.8% (10 of 172), P < 0.001]. Multivariate analysis identified BAV-MSBC [odds ratio (OR) = 10.15, 95% confidence interval (CI): 4.07-25.34, P < 0.001], previous AVB I (OR = 4.15, 95% CI: 1.32-13.04, P = 0.015) and right bundle branch block (OR = 26.39, 95% CI: 4.81-144.82, P < 0.001) as risk factors of PPMI, while △MSID-RCC (OR = 0.78, 95% CI: 0.70-0.86, P < 0.001) was protective. The multivariate model had an AUC of 0.887 (95% CI: 0.843-0.930).
CONCLUSION: PPMI risk differs significantly between BAV subtypes, possibly due to variations in MS proximity to the stent. The new BAV classification method may improve PPMI risk prediction and patient management.
METHODS AND RESULTS: We retrospectively analyzed 300 BAV patients with severe aortic stenosis who underwent self-expanding TAVI. Based on leaflet morphology and calcification severity at the commissure between right coronary cusp (RCC) and non-coronary cusp (NCC), BAVs were classified into two subtypes: BAV with MS below commissure (BAV-MSBC) and BAV with MS below leaflet (BAV-MSBL). Univariate and multivariate logistic regressions were performed to identify potential risk factors of PPMI. PPMI rate differed significantly between BAV-MSBC and BAV-MSBL [32.8% (42 of 128) vs. 5.8% (10 of 172), P < 0.001]. Multivariate analysis identified BAV-MSBC [odds ratio (OR) = 10.15, 95% confidence interval (CI): 4.07-25.34, P < 0.001], previous AVB I (OR = 4.15, 95% CI: 1.32-13.04, P = 0.015) and right bundle branch block (OR = 26.39, 95% CI: 4.81-144.82, P < 0.001) as risk factors of PPMI, while △MSID-RCC (OR = 0.78, 95% CI: 0.70-0.86, P < 0.001) was protective. The multivariate model had an AUC of 0.887 (95% CI: 0.843-0.930).
CONCLUSION: PPMI risk differs significantly between BAV subtypes, possibly due to variations in MS proximity to the stent. The new BAV classification method may improve PPMI risk prediction and patient management.