Study On The Predictive Factors Of Preoperative Measurement Parameters Of TAVR For Postoperative Perivalvular Leakage

Objective: To investigate the risk factors for perivalvular leakage(PVL)after transcatheter aortic valve replacement(TAVR)implantation of self-expanding heart valve in patients with severe stenosis of the aorta(AS),and to provide some clinical guidance.Data and methods: Retrospectively and continuously selected patients who undergo TAVR in our hospital from October 2017 to December 2022,collected their clinical data,surgical data,ultrasound data and preoperative imaging data,and divided into no/trace PVL group and PVL group according to the postoperative pre-discharge ultrasound results,and compared the differences in clinical general data and imaging measurement indicators.The logistic regression model was used to analyze the independent risk factors of PVL and the ROC curve to analyze the predictive value of each risk factor on PVL.Results: Sixty-seven patients were enrolled,39% were male,with a mean age of72.76±8.59,and 45(67.2%)divided into PVL group,univariate analysis found that the two groups had statistical significance in area oversize index,diameter oversize index,left side of implantation depth,right side of implantation depth,mean implantation depth,left ventricular outflow tract(LVOT)calcification ratio,annular eccentricity and other indicators.Because some variables are collinear,the area oversize index,mean implant depth and LOVT calcification are included in multivariate logistic regression analysis,and it is shown that mean implant depth(OR=6.854,95%CI 1.050～44.743,P=0.044)and LOVT calcification(OR=4.691,95%CI 1.332～16.520,P=0.016)are independent risk factors for mild or above PVL after TAVR,and The curve areas are respectively(0.701,95%CI 0.559～0.842,P=0.008)、(0.697,95%CI 0.565～0.830,P=0.009).Conclusion: The results of this study show that the depth of valve implantation and the presence of LOVT calcification are independent risk factors for mild and above PVL after TAVR implantation of self-expanding valve,and have good predictive value.