{"id":"da337bbfdb73","type":"article","url":"https://hartvaat.nl/2026/12/01/paravalklekrapping-verslechtert-kort-na-tavi-kleversie-en-ldh-als-voorspellers/","title":"Paravalklekrapping verslechtert kort na TAVI — kleversie en LDH als voorspellers","title_en":"Association Between Changes in Paravalvular Leakage After Transcatheter Aortic Valve Implantation and Serum Lactate Dehydrogenase.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Cardiology research","doi":"10.14740/cr2307","source_url":"https://doi.org/10.14740/cr2307","authors":["Akihiro Ikuta","Gakuto Bando","Satoki Oka","Shunsuke Matsushita","Naoya Inoue","Shingo Hirao","Mitsuru Abe","Kazushige Kadota","Tatsuhiko Komiya","Yasushi Fuku"],"significance":5,"published":"2026-11-09","source_date":"2026-12-01","image":"","kennis":["https://hartvaat.nl/kennis/kleplijden/aortastenose/","https://hartvaat.nl/kennis/kleplijden/tavi-transcatheter-aortaklepimplantatie/"],"congress":"","summary_en":"In a cohort of 313 patients undergoing TAVI with balloon-expandable valves, paravalvular leakage (PVL) worsened in 16.3% between the immediate post-procedure period and hospital discharge. Patients with PVL deterioration had a significantly higher incidence of moderate-to-severe LDH elevation at day 7 (17.6% vs. 8.4%) and at one month (29.4% vs. 8.8%). Multivariable analysis identified a sizing index below 96.5%, high aortic calcium scores, and use of the SAPIEN 3 Ultra RESILIA valve as independent predictors of PVL worsening. These findings underscore the importance of precise valve sizing to minimize early PVL deterioration and associated biomarker changes.","created":"2026-11-03T02:06:24Z","updated":"2026-11-03T02:06:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een cohortstudie onder 313 patiënten die een TAVI ondergingen met een balloon-expandable klep, toonde aan dat de paravalklekrapping (PVL) bij 16,3% verslechterde van direct postoperatief tot ontslag. Patiënten met PVL-verslechtering hadden significant vaker een matige of ernstige LDH-stijging op dag 7 (17,6% vs. 8,4%) en na één maand (29,4% vs. 8,8%). Een kleversie (sizing index) onder 96,5%, een hoge calciumscore en het gebruik van de SAPIEN 3 Ultra RESILIA-klep waren onafhankelijk geassocieerd met deze verslechtering. Voor de structuurcardioloog benadrukt dit onderzoek het belang van een nauwkeurige kleversie om PVL te minimaliseren en mogelijk LDH-stijgingen te voorkomen.","abstract_original":"BACKGROUND: The association between changes in paravalvular leakage (PVL) and serum lactate dehydrogenase (LDH) levels in patients undergoing transcatheter aortic valve implantation (TAVI) is unexplored. We aimed to investigate the short-term changes in PVL after TAVI and their association with LDH elevation. METHODS: A total of 550 consecutive patients underwent TAVI from 2020 to 2024. Of these, 313 receiving SAPIEN 3 (S3) or SAPIEN 3 Ultra RESILIA (S3UR) valves were included in this study. Patients were categorized into two groups based on whether their PVL severity worsened by at least one grade from immediately after the procedure to hospital discharge. RESULTS: PVL deterioration was observed in 16.3% of patients. The incidence of moderate or greater LDH elevation was significantly higher in the PVL deterioration group than in the non-PVL deterioration group at 7 days (17.6% vs. 8.4%; P = 0.04) and 1 month (29.4% vs. 8.8%; P < 0.01) after the procedure. The area under the receiver operating characteristic (ROC) curve for predicting PVL deterioration using the sizing index (SI) was 0.84, with an optimal cut-off value of 96.5% (odds ratio (OR): 13.6; 95% confidence interval (CI): 6.55-31.1; P < 0.01). Multivariable analysis showed that an aortic valve calcium score ≥ 1,435, use of the S3UR valve, and an SI < 96.5 were independently associated with PVL deterioration. CONCLUSION: Early PVL deterioration after TAVI with a balloon-expandable valve may be associated with LDH elevation. These findings highlight the importance of selecting a prosthetic valve with an appropriate sizing ratio to minimize PVL deterioration after TAVI."}