BACKGROUND The role of basal septal hypertrophy (BSH) on preprocedural transthoracic echocardiography in transcatheter aortic valve replacement (TAVR) is unknown. METHODS Medical charts and preprocedural transthoracic echocardiograms of 378 patients who underwent TAVR were examined. The association between BSH and the primary composite outcome of valve pop-out, recapture, embolization, aborted procedure, conversion to open procedure, new conduction disturbance, or need for permanent pacemaker ≤30 days after TAVR was evaluated. Patients with preexisting pacemakers were excluded. Sensitivity analyses were performed varying the definition of BSH. RESULTS Of 296 TAVR patients (78.3%) with interpretable images, 55 (18.6%) had BSH at a median of 40 days (interquartile range, 19-62 days) before TAVR. Age and sex were similar among those with and without BSH. BSH patients received postdilation more frequently (BSH+ vs BSH-: 41.8% vs 29.9%, P = .04). A total of 50 individuals (16.9%) received pacemakers within 30 days, and 128 (43.2%) developed conduction disturbances (with left bundle branch block most common), without differences between groups. BSH was unrelated to the primary outcome on multivariate analysis (adjusted odds ratio BSH+ vs BSH-, 0.94; 95% CI, 0.42-2.11; P = .88). CONCLUSIONS In this convenience sample of TAVR recipients at a large academic medical center, patients with BSH were more likely to receive postdilation. BSH was not associated with procedural or conduction outcomes after TAVR in patients without preexisting pacemakers.

中文翻译：

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基底间隔肥厚对经导管主动脉瓣置换术后结果的影响。

背景 基底间隔肥厚 (BSH) 对经导管主动脉瓣置换术 (TAVR) 术前经胸超声心动图的作用尚不清楚。方法 对 378 名接受 TAVR 的患者进行医疗图表和术前经胸超声心动图检查。评估了 BSH 与瓣膜弹出、重新捕获、栓塞、手术中止、转为开放手术、新的传导障碍或 TAVR 后 30 天以内需要永久性起搏器等主要复合结局之间的关联。已有起搏器的患者被排除在外。根据不同的 BSH 定义进行了敏感性分析。结果 在具有可判读图像的 296 名 TAVR 患者 (78.3%) 中，55 名 (18.6%) 在 TAVR 前平均 40 天（四分位距，19-62 天）接受了 BSH。患有和未患有 BSH 的患者的年龄和性别相似。BSH 患者接受后扩张的频率更高（BSH+ vs BSH-：41.8% vs 29.9%，P = .04）。共有 50 人（16.9%）在 30 天内接受起搏器治疗，128 人（43.2%）出现传导障碍（左束支传导阻滞最常见），组间无差异。BSH 与多变量分析的主要结果无关（调整后的比值比 BSH+ 与 BSH-，0.94；95% CI，0.42-2.11；P = .88）。结论 在大型学术医疗中心 TAVR 接受者的方便样本中，BSH 患者更有可能接受后扩张。对于没有预先安装起搏器的患者，BSH 与 TAVR 后的手术或传导结果无关。