The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Long-term follow-up of patients with Contained Annulus Ruptures after TAVI: the EuropeaN COntained RupturE ENCORE-registry

DOI: 10.4244/EIJ-D-19-00740

1. Division of Cardiology & Angiology II, University Heart Center Freiburg-Bad Krozingen, Germany, Germany
2. Department of Radiology, Section of Cardiovascular Radiology, University of Freiburg, Germany
3. Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
4. The Heart Center, Department of Cardiology Rigshospitalet University of Copenhagen, Copenhagen, Denmark
5. Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, United Kingdom
6. Department of Cardiology, Heart Center Leipzig – University Hospital, Leipzig, Germany
7. Division of Cardiology, Robert-Bosch-Medical Center Stuttgart, Stuttgart, Germany
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Aims: The purpose of this registry was to determine the long-term outcomes in patients with asymptomatic contained annulus rupture (CR) as a rare complication of transcatheter aortic valve implantation (TAVI).

Methods and results: The ENCORE-registry is a multicenter registry (6 centers across Europe) of patients with CR diagnosed on post-TAVI computed tomography angiography (CTA) or transoesophageal echocardiography (TEE). A total of 21 patients (mean age 81.9±4.1 years, 81% balloon-expandable TAVI-prostheses) were diagnosed with CR (mean size of lesions was 15.3±6.9 x 8.5±3.3 x 8.5±2.3 mm). Seventeen were diagnosed among a total of 1602 consecutive routine post-TAVI CTA (incidence 1.1%), two in TEE and two in post-TAVI CTA (each conducted due to suspicion of peri-interventional complications). During a mean follow-up of 2.3±1.7 years (cumulative 48.6 patient years) nine patients (43%) died from non-cardiac causes. None of the patients exhibited symptoms or underwent interventional treatment related to the CR, no sudden cardiac death occurred. A follow-up CTA, performed in eleven patients 240±176 days post-TAVI, revealed stable CR findings in seven, regression in one, and remission in three patients.

Conclusions: The results of our international multicenter registry demonstrate favourable long-term outcomes of CR after TAVI supporting a watch-and-wait strategy in these patients.

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