The Impact of Basal Septal Hypertrophy on Outcomes after Transcatheter Aortic Valve Replacement, JASE, November 2019

The Impact of Basal Septal Hypertrophy on Outcomes after Transcatheter Aortic Valve Replacement, JASE, November 2019


Identification: TJC1210
Credits (Post Test and/or Evaluation Required)
Available until
  • 1.00 - Physician
  • 1.00 - Non-Physician

ASE Members: $0.00
Standard: $15.00

Description

December 10, 2019

8:00 PM - 9:00 PM (EST)

Hosted By: TBA

CME Information: 1.0 Credit

Introduction:

Within the past decade, transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic valve replacement for patients at intermediate to high surgical risk with symptomatic severe aortic stenosis.1-4 With growth in the use of TAVR, increasing attention has been given to TAVR-related complications, particularly the development of complete heart block and the need for a permanent pacemaker (PPM).5 Despite improvements in TAVR technology and increasing experience with implementation, the use of PPMs has not declined but in fact has increased. In this setting, it has been hypothesized that basal septal hypertrophy (BSH), a localized thickening of the basal portion of the left ventricular septum that associates with increased age and long-standing hypertension, could contribute to the development of conduction and mechanical complications after TAVR. The basal septum is in close proximity to both the aortic valve and the bundle of His, and localized hypertrophy at this site could contribute to procedural difficulty during TAVR and an increased risk for conduction disturbance and periprocedural complications, including PPM placement, valve pop-out, need for valve recapture, device embolization, conversion to an open procedure, or need to abort the procedure. Despite the possible concerns about BSH’s impact on outcomes, there exist few data on the outcomes of patients with BSH undergoing TAVR. We therefore conducted a retrospective chart review of individuals undergoing TAVR at Beth Israel Deaconess Medical Center (BIDMC) to evaluate the impact of BSH on periprocedural and 30-day mechanical and electrical complications.

Learning Objectives:

After completing this activity, participants should be better able to:

  • Understand the definition of basal septal hypertrophy (BSH) and prevalence in individuals with severe aortic stenosis receiving transcatheter aortic valve replacement (TAVR).
  • Learn the anatomy of the basal interventricular septum and relationship to the cardiac conduction system.
  • Appreciate the impact of BSH on clinical outcomes after TAVR.

**IMPORTANT: Registration Instructions**

  • Registration is required to receive credit. All credit must be claimed within 30 days of the event date.

Credits

  • 1.00 - Physician
  • 1.00 - Non-Physician

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