One hundred two consecutive patients who underwent TAVI were submitted to transthoracic echocardiography immediately before and after aortic valve implantation, together with invasive hemodynamic measurements.
After TAVI, immediate reductions in the transaortic peak pressure gradient (P < .0001) and mean pressure gradient (P < .0001) and a concomitant increase in aortic valve area (P < .0001) were seen on echocardiography. Left ventricular ejection fraction significantly increased immediately after TAVI in all patients (from 48.9 ¡À 10.3 % to 52.1 ¡À 11.1 % , P < .0001). Regarding global left ventricular hemodynamic load, acute and significant reductions in end-systolic meridional wall stress (from 82.7 ¡À 42.6 to 57.8 ¡À 30.1 kdyne ¡¤ cm?, P < .0001) and in Zva (from 6.81 ¡À 2.51 to 5.38 ¡À 2.13 mm Hg ¡¤ mL? ¡¤ m?, P < .0001) were observed. Furthermore, patients who died at 6-month follow-up had higher baseline Zva values compared with those who were alive at 6-month follow-up (8.13 ¡À 3.08 vs 6.41 ¡À 2.12 mm Hg ¡¤ mL? ¡¤ m?, P < .004).
TAVI is characterized by an immediate enhancement of global left ventricular hemodynamic performance, as demonstrated by an acute Zva improvement, even in patients with low baseline ejection fractions.