By Ahmed El-Medany
Longer door-to-balloon times and higher percutaneous coronary intervention (PCI) failure rate were observed in a multicentre study by Faroux et al.
118 patients presenting with STEMI following transcutaneous aortic valve replacement (TAVR) were analysed and compared to 439 ‘non-TAVR’ STEMI patients.
Results suggested that median door-to-balloon time was 40 minutes in the TAVR group (IQR, 25-57) and 30 minutes in the non-TAVR group (IQR, 25-30; P = .003). A door-to-balloon time of 60 minutes or more occurred in 20.8% of the TAVR group and 8.6% of patients in the non-TAVR group (P = .005).
Furthermore, procedural time, fluoroscopy time, dose-area product and contrast volume were also elevated in patients assigned TAVR (P < .01), and PCI failure occurred more frequently in patients with previous TAVR (16.5% vs. 3.9%; P < .001).
In the TAVR group, 25.4% of patients died in hospital (20.6% of those who had primary PCI) and 42.4% of patients died at a median of 7 months (IQR, 1-21) after hospitalisation.
According to the researchers, longer door-to-balloon times and higher PCI failure rate were ‘partially due to coronary access issues specific to the TAVR population.’
Faroux, L., Lhermusier, T., Vincent, F., Nombela-Franco, L., Tchétché, D., Barbanti, M., Abdel-Wahab, M., Windecker, S., Auffret, V., Campanha-Borges, D.C. and Fischer, Q., 2021. ST-Segment Elevation Myocardial Infarction Following Transcatheter Aortic Valve Replacement. Journal of the American College of Cardiology, 77(17), pp.2187-2199.