Long-Term Results of Transcatheter Aortic Valve Replacement for Concomitant Dilatation of the Ascending Aorta

Aim: to evaluate the dynamics of changes in the diameter of the initially dilated ascending aorta and aortic root up to 6.5 years after the TAVI procedure.

Materials and methods: a single-center retrospective study included 50 patients diagnosed with severe aortic stenosis who underwent TAVI and had a preoperative ascending aorta size of ≥40 mm and ≤50 mm. The maximum follow-up period was 6.5 years; the average follow-up period was 40 months. The primary endpoint was the fact of changes in the sizes of the ascending aorta and aortic root after the TAVI procedure according to echocardiography.

Results: in the study cohort, the maximum diameter of the ascending aorta statistically insignificantly decreased in the remote period (42.28±2.12 mm versus 41.84±3 mm, respectively, p=0.2). The diameter at the level of the sinuses of Valsalva increased statistically insignificantly (35.66±3.65 mm versus 35.82±4.05 mm, respectively, p=0.72). There was a statistically significant increase in the diameter in the remote period at the level of the sinotubular junction (31.32±4.53 mm versus 33±5.23 mm, respectively, p=0.01). According to the results of Cox regression, no predictors of an increase in the size of the sinotubular junction in the remote period were found.

Conclusion: in the group of patients with initially existing dilation of the ascending aorta, no significant increase in the diameter of this section was noted up to 6.5 years after TAVI using the MedLAB-KT balloon-expandable prosthesis. A tendency towards an increase in the diameter of the sinotubular junction in the remote period after the intervention was revealed; Cox regression analysis did not reveal any independent predictors of dilation of this aortic root element.

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