The purpose of this study is to help understand how the replacement valve functions over time, both at rest and during exercise.
The objective of this single-center registry is to evaluate prosthetic valve hemodynamics and function over time in patients undergoing clinically indicated transcatheter aortic valve replacement (TAVR) for symptomatic severe aortic stenosis. Specific goals include: * Describe valve hemodynamics at rest (baseline, post-procedure, 30 days, 1 year) and with exercise (at 30 days and 1 year) after TAVR implantation to define valve function and hemodynamics over time. * Compare valve hemodynamics and function at rest and exercise between self-expanding and balloon expandable valves.
Study Type
OBSERVATIONAL
Enrollment
28
Yale New Haven Hospital
New Haven, Connecticut, United States
TransAortic Valve Gradient during exercise at 12 months post-TAVR
TransAortic Valve Gradient (mmHg) during exercise as assessed by the Echocardiographic Core Laboratory and summarized as peak and mean.
Time frame: 12 months post-TAVR
Change in valve cusp thickness at rest
Change in valve cusp thickness (mm) at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in valve mobility at rest
Change in valve mobility at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in paravalvular leak at rest
Change in paravalvular leak at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in coefficient of contraction Effective Orifice Area (EOA)/Geometric Orifice Area (GOA) at rest
Change in coefficient of contraction EOA/GOA at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in Dimensionless Velocity Index (DVI) at rest
Change in DVI at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
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Change in energy loss coefficient at rest
Change in energy loss coefficient at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in EOA at rest
Change in EOA (cm2) at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in aortic valve gradient (peak and mean) at rest
Change in aortic valve gradient (mmHg) (peak and mean) at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in aortic valve velocity (peak and mean) at rest
Change in aortic valve velocity (m/s) (peak and mean) at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in Left Ventricle (LV) remodeling at rest
Change in LV remodeling at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in leaflet thickening at rest
Change in leaflet thickening at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in coaptation length at rest
Change in coaptation length (mm) at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in LV thickness at rest
Change in LV thickness (cm) at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in LV Global Longitudinal Strain at rest
Change in LV Global Longitudinal Strain (%) at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in Right Ventricular (RV) systolic velocity at rest
Change in RV systolic velocity (cm/s) at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in RV systolic pressure (RVSP) at rest
Change in RVSP (mmHg) at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in Tricuspid Annular Plane Systolic Excursion (TAPSE) at rest
Change in TAPSE (mm) at rest assessed using echocardiogram reported as absolute values and as changes.
Time frame: baseline, during hospitalization approximatively 3 days, 30 days, and 12 months post-TAVR
Change in aortic valve gradient (peak and mean) with exercise
Change in gradient (mmHg) (peak and mean) with exercise assessed using echocardiogram reported as absolute values and as changes.
Time frame: 30 days, and 12 months post-TAVR
Change in aortic valve velocity (peak and mean) with exercise
Change in aortic valve velocity (m/s) (peak and mean) with exercise assessed using echocardiogram reported as absolute values and as changes.
Time frame: 30 days and 12 months post-TAVR
Change in DVI with exercise
Change in DVI with exercise assessed using echocardiogram reported as absolute values and as changes.
Time frame: 30 days and 12 months post-TAVR
Change in EOA with exercise
Change in EOA (cm2) with exercise assessed using echocardiogram reported as absolute values and as changes.
Time frame: 30 days and 12 months post-TAVR
Change in RVSP with exercise
Change in RVSP (mmHg) with exercise assessed using echocardiogram reported as absolute values and as changes.
Time frame: 30 days and 12 months post-TAVR
Change in exercise duration
Change in exercise duration (min) reported as absolute values and as changes.
Time frame: 30 days and 12 months post-TAVR
Change in LV Global Longitudinal Strain with exercise
Change in LV Global Longitudinal Strain (%) with exercise assessed using echocardiogram reported as absolute values and as changes.
Time frame: 30 days and 12 months post-TAVR
TAVR Device Success (Valve Academic Research Consortium [VARC]-defined)
TAVR Device Success evaluated post-procedure/pre-discharge during hospitalization approximatively 3 days, defined as: absence of procedural mortality AND correct positioning of a single prosthetic heart valve into the proper anatomical location AND intended performance of the prosthetic heart valve (defined as no prosthesis-patient mismatch \[VARC-defined\] and mean aortic valve gradient \<20 mm Hg or peak velocity \<3 m/s, AND no moderate or severe prosthetic valve regurgitation \[VARC-defined\] \[site and Core Laboratory-reported\].
Time frame: during hospitalization approximatively 3 days
Composite Safety Endpoints (VARC-3 defined)
Composite safety endpoint reported as a proportion of participants who died or experienced neurological events or life-threatening bleeding or acute kidney injury or coronary artery obstruction requiring intervention or major vascular complications or valve-related dysfunction requiring repeat procedure evaluated at 30 days and 12 months.
Time frame: 30 days and 12 months post-TAVR