Effect of transcatheter aortic valve implantation on the ascending aorta's elasticity.

Background: The elastic properties of the ascending aorta were studied before and 1 week after transcatheter aortic valve implantation (TAVI). Previous studies have shown that the distensibility of the ascending aorta was decreased in the early post-operative period after aortic valve replacement. Aortic stiffness is a major moderator of arterio-ventricular coupling and an independent predictor of cardiovascular risk and mortality. We evaluated the effect of TAVI on the elastic properties of the ascending aorta in the early post-operative period.

Methods: Aortic distensibility (AD) and Aortic Stiffness Index (ASI) were evaluated using echocardiographic techniques and brachial artery pressure obtained by sphygmomanometry 2-3 days before and 7-8 days after TAVI.

Results: A total of 30 patients (14 males) were studied with a mean age of 79.9 ± 4.7 years and aortic valve area before TAVI of 0.61 ± 0.16 cm(2). Mean arterial pressure decreased significantly after TAVI (from 89.6 ± 8.9 mmHg to 83.3 ± 10.9 mmHg, p = 0.004). AD did not change significantly after TAVI (pre: 1.89 ± 1.11 cm(2)/(dynes × 10(6)), post: 2.05 ± 1.50 cm(2)/(dynes × 10(6)); p = 0.813). ASI also remained unchanged (pre: 11.4 ± 6.5, post: 15.6 ± 14.9; p = 0.349).

Conclusions: The elastic properties of the ascending aorta did not change significantly in the early post-procedural period after TAVI. This may in part be attributable to the less invasive procedure (compared to aortic valve replacement) which has no effect on vasa vasorum flow.