Untersuchungen zur nichtinvasiven Hämodynamik nach Transkatheter Aortenklappenersatz unter Berücksichtigung der Low Gradient Aortenklappenstenose

The aim of this study was to assess the short-term changes in hemodynamics after implantation of a transfemoral aortic valve replacement, with a special focus on the differences between low gradient aortic stenosis and non low gradient aortic stenosis patients. For this purpose, the Non Invasive Cardiac System, based on the bioimpedance method, was used to determine hemodynamics at three different time points, before implantation, 6-8 hours, and 3-5 days after TAVI. In addition, the so-called EQ-5D-5L questionnaire was elicited in part of the patients to determine the quality of life before TAVI in the hospital and 3 months after implantation. There was a significant improvement, especially in the Cardiac Index and a decrease in total peripheral resistance in both subgroups 3-5 days after implantation. In the low gradient aortic stenosis subgroup, there was a more significant increase in Cardiac Index as well as a more significant decrease in total peripheral resistance than in the non low gradient aortic stenosis subgroup. In addition, it was demonstrated that there was a significant increase in Granov Goor Index 3-5 days after TAVI, which is an indicator of left ventricular systolic contractile function, in the Low Gradient Aortic Stenosis group. Quality of life also increased significantly in participating patients, from an average score of 53.05±17.87 within the 3 months to 60.61±16.29. In general, both subgroups were shown to benefit from TAVI implantation both hemodynamically and according to their subjectively perceived quality of life. Of particular note is the more pronounced benefit of low gradient aortic valve stenosis patients compared with nonlow gradient aortic valve stenosis patients. This also reflects the adequate timing of therapy for the patient population presented here at the University Heart Center.