{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T06:27:34Z","timestamp":1771568854845,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Persistent left bundle branch block (P-LBBB) has been associated with poor clinical outcomes of transcatheter aortic valve implantation (TAVI) procedures. We hypothesized that the distance from the aortic valve to the proximal conduction system, expressed as the effective distance between the aortic valve and conduction system (EDACS), can predict the occurrence of P-LBBB in patients undergoing a TAVI procedure. Materials and methods: In a retrospective study, data from 269 patients were analyzed. EDACS was determined using two longitudinal CT sections. Results: Sixty-four of the patients developed P-LBBB. EDACS ranged between \u22123 and +18 mm. EDACS was significantly smaller in P-LBBB than in non-P-LBBB patients (4.6 (2.2\u20137.1) vs. 8.0 (5.8\u201310.2) mm, median values (interquartile range); p &lt; 0.05). Receiver operating characteristic analysis showed an area under the curve of 0.78 for predicting P-LBBB based on EDACS. In patients with EDACS of \u22643 mm and &gt;10 mm, the chance of developing P-LBBB was \u226550% and &lt;10%, respectively. Conclusions: A small EDACS increases the risk for the development of P-LBBB during TAVI by a factor of &gt;25. As EDACS can be measured pre-procedurally, it may be a valuable additional factor to weigh the risks of transcatheter and surgical aortic valve replacement.<\/jats:p>","DOI":"10.3390\/medicina57050476","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T11:30:16Z","timestamp":1620732616000},"page":"476","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effective Distance between Aortic Valve and Conduction System Is an Independent Predictor of Persistent Left Bundle Branch Block during Transcatheter Aortic Valve Implantation"],"prefix":"10.3390","volume":"57","author":[{"given":"Thomas T.","family":"Poels","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Maastricht University Medical Center, P.O. Box 5800, 6229HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Stassen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Maastricht University Medical Center, P.O. Box 5800, 6229HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Kats","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Maastricht University Medical Center, P.O. Box 5800, 6229HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo","family":"Veenstra","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Center, P.O. Box 5800, 6229HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"van Ommen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Center, P.O. Box 5800, 6229HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastiaan","family":"Kietselaer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Center, P.O. Box 5800, 6229HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Houthuizen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Catharina Hospital Eindhoven, P.O. Box 1350, 5623EJ Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos G.","family":"Maessen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Maastricht University Medical Center, P.O. Box 5800, 6229HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frits W.","family":"Prinzen","sequence":"additional","affiliation":[{"name":"CARIM School for Cardiovascular Diseases, P.O. Box 616, 6229ER Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.jacc.2009.12.014","article-title":"Transcatheter aortic valve implantation for the treatment of severe symptomatic aortic stenosis in patients at very high or prohibitive surgical risk: Acute and late outcomes of the multicenter Canadian experience","volume":"55","author":"Webb","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jacc.2007.04.047","article-title":"Percutaneous aortic valve replacement for severe aortic stenosis in high-risk patients using the second- and current third-generation self-expanding CoreValve prosthesis: Device success and 30-day clinical outcome","volume":"50","author":"Grube","year":"2007","journal-title":"J. Am. Coll. 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