Correlation between Aortic Valve and Vascular Calcium Score in Pre TAVI-CT with In-Hospital and ShortTerm Outcome Post TAVI

Background: Aortic valve stenosis (AS) is the most common valvular pathology, affecting 2–4% of patients over 75 years. More than one-third of high-risk AS patients are not fit for major surgery. TAVI has become a well-established treatment for severe AS. This study aimed to evaluate early complications and short-term outcomes after TAVI and their correlation with the Calcium Score (CS) of the aortic valve, aorta, and ilio-femoral arteries from pre-procedural CT. Methods: This prospective study included 60 AS patients undergoing TAVI at Nasr City Insurance Hospital. All patients underwent history taking, clinical examination, laboratory tests, ECG, echocardiography, and CT angiography. CS was calculated using Agatston units (AU) with Philips HeartBeat software. The analyzed regions included the aortic valve, aorta (ascending to aorto-iliac carrefour), and ilio-femoral arteries. Patients were followed for 3 months. Results: Patients were classified into four quartiles (Q1–Q4) based on CS. Para-valvular leak occurred in 33.3% (Q1), 53.3% (Q2), 60% (Q3), and 73.3% (Q4) (P < 0.001). AV block was observed in 1 case (Q1), 2 cases (Q2, Q3), and 1 case (Q4) (P > 0.05). Stroke occurred in 1 Q4 patient. Vascular complications occurred in 13.3% (Q1, Q2), 26.7% (Q3), and 46.7% (Q4) (P < 0.001). Aortic Valve CS predicted para-valvular leak (AUC= 0.733, sensitivity= 77.8%, specificity= 62.5%, P= 0.002), while Iliofemoral CS predicted vascular complications (AUC = 0.744, sensitivity = 66.7%, specificity= 82.2%, P= 0.005). Conclusions: Pre-procedural CS of the aortic valve, aorta, and ilio-femoral arteries is a predictor of early complications post-TAVI.