{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:27:03Z","timestamp":1787761623005,"version":"build-2784847793"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T00:00:00Z","timestamp":1644710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cardiac Surgery"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the impact of left ventricle outflow tract calcification (LVOT) on the outcomes of transcatheter aortic valve implantation (TAVI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Meta\u2010analysis including studies published by October 2021. Primary endpoints were operative and 1\u2010year mortality. The secondary endpoints were stroke, myocardial infarction, paravalvular leakage (PVL), new permanent pacemaker implantation (PPI), aortic annulus\/root rupture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies met our eligibility criteria, including a total of 4459 patients (1330 patients with significant LVOT calcification and 3129 patients without significant LVOT calcification). Pooled risk of operative death was higher in the group with significant LVOT calcification (odds ratio [OR]: 2.28; 95% confidence interval [CI]: 1.33\u20133.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Worse 1\u2010year survival was observed in the group with LVOT calcification (hazard ratio 1.53, 95% CI: 1.26\u20131.87,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Patients with significant LVOT calcification had higher risk of stroke (OR: 1.83; 95% CI: 1.08\u20133.09;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.032), myocardial infarction (OR: 1.74; 95% CI: 1.08\u20132.80;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.034), PVL (OR: 1.88; 95% CI: 1.09\u20133.22;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.028) and aortic annulus\/root rupture (OR: 7.48; 95% CI: 3.58\u201315.65;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.002). We did not observe a statistically significant difference in the pooled results for new PPI between the groups (OR: 1.19; 95% CI: 0.79\u20131.80;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.337).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The presence of significant LVOT calcification increases the risk of periprocedural and 1\u2010year mortality, stroke, myocardial infarction, PVL and aortic annulus\/root rupture after TAVI. Self\u2010expandable valves may be a preferrable option in this scenario. Structural heart surgeons and interventional cardiologists should consider this factor when referring patients for TAVI and technical aspects (such as the type of transcatheter heart valve to be deployed or the use of pre\u2010\/post\u2010dilatation) should be factored in.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocs.16306","type":"journal-article","created":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T05:03:57Z","timestamp":1644728637000},"page":"1379-1390","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Impact of left ventricle outflow tract calcification on the outcomes of transcatheter aortic valve implantation: A study\u2010level meta\u2010analysis"],"prefix":"10.1155","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-2996","authenticated-orcid":false,"given":"Michel Pompeu","family":"S\u00e1","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center Main Line Health  Wynnewood Pennsylvania USA"},{"name":"Department of Cardiothoracic Surgery Research Lankenau Institute for Medical Research  Wynnewood Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5606-376X","authenticated-orcid":false,"given":"Jef","family":"Van den Eynde","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences KU Leuven  Leuven Belgium"},{"name":"Helen B. Taussig Heart Center The Johns Hopkins Hospital and School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Malin","sequence":"additional","affiliation":[{"name":"Philadelphia College of Osteopathic Medicine  Bala Cynwyd Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Torregrossa","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center Main Line Health  Wynnewood Pennsylvania USA"},{"name":"Department of Cardiothoracic Surgery Research Lankenau Institute for Medical Research  Wynnewood Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1822-768X","authenticated-orcid":false,"given":"Serge","family":"Sicouri","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Research Lankenau Institute for Medical Research  Wynnewood Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basel","family":"Ramlawi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center Main Line Health  Wynnewood Pennsylvania USA"},{"name":"Department of Cardiothoracic Surgery Research Lankenau Institute for Medical Research  Wynnewood Pennsylvania 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