Imaging, Valvular and Procedural Predictors
Presence of high calcium volume extending into LVOT in the area below the left coronary cusp (LVOTlc) (OR 4.21, 95% CI 1.90-9.31; p < 0.01; I2 = 0%) and non-coronary cusp (LVOTnc) (OR 3.15, 95% CI 1.26-7.88; p = 0.01; I2 = 89%) was a significant predictor while presence of high calcium in the area below the right coronary cusp (LVOTrc) was not. Implantation of MCRS valve was associated with a 3.47-fold increased risk of PPMI compared with ESV (OR 3.47, 95% CI 1.75-6.88; p < 0.01; I2 = 96%). Implant depth (OR 1.24, 95% CI 1.11-1.40; p < 0.01; I2 = 85%) and increased valve size/annulus size were also found to carry enhanced risk (OR 1.14, 95% CI 1.02-1.27; p = 0.02; I2 = 80%); however, IVSD was not found to be a significant predictor. Pre-dilatation balloon valvuloplasty and post-implant balloon dilation were identified as notable predictors with OR 2.32 (95% CI 1.56-3.44; p < 0.01; I2 = 47%) and 1.76 (95% CI 1.10-2.82; p = 0.02; I2 = 15%) respectively. Presence of post-procedure AVB was also found to be important (OR 3.08, 95% CI 1.34-7.10; p < 0.01; I2 = 90%).