Prognostic role of pre-procedural lung ultrasound in patients undergoing transcatheter aortic valve implantation

BackgroundTranscatheter aortic valve implantation (TAVI) is the preferred treatment for patients with severe aortic stenosis (AS) in patients >75 years. Lung ultrasound (LUS) has emerged as a noninvasive tool for assessing pulmonary congestion and risk stratification in cardiovascular disease...

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Main Authors: Guilherme Pinheiro Machado, Pedro Castilhos de Freitas Crivelaro, Gustavo Neves de Araujo, Guilherme Heiden Telo, Luiz Carlos Corsetti Bergoli, Marina Petersen Saadi, Julia Carvalho da Silva, Camila Porto Cardoso, Wagner Azevedo, Felipe Costa Fuchs, Marco Wainstein
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1626497/full
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author Guilherme Pinheiro Machado
Pedro Castilhos de Freitas Crivelaro
Gustavo Neves de Araujo
Guilherme Heiden Telo
Luiz Carlos Corsetti Bergoli
Marina Petersen Saadi
Julia Carvalho da Silva
Camila Porto Cardoso
Wagner Azevedo
Felipe Costa Fuchs
Marco Wainstein
author_facet Guilherme Pinheiro Machado
Pedro Castilhos de Freitas Crivelaro
Gustavo Neves de Araujo
Guilherme Heiden Telo
Luiz Carlos Corsetti Bergoli
Marina Petersen Saadi
Julia Carvalho da Silva
Camila Porto Cardoso
Wagner Azevedo
Felipe Costa Fuchs
Marco Wainstein
author_sort Guilherme Pinheiro Machado
collection DOAJ
description BackgroundTranscatheter aortic valve implantation (TAVI) is the preferred treatment for patients with severe aortic stenosis (AS) in patients >75 years. Lung ultrasound (LUS) has emerged as a noninvasive tool for assessing pulmonary congestion and risk stratification in cardiovascular disease, especially heart failure, however, its prognostic role in TAVI remains to be clarified. Therefore, our aim was to investigate the association between pre-procedural LUS findings and clinical outcomes in patients undergoing TAVI.MethodsWe conducted a prospective cohort study of 116 patients undergoing TAVI from 2021 to 2024. Lung ultrasound was performed immediately before the procedure. Patients were classified as having “wet lungs” (≥1 positive zone) or “dry lungs” (no positive zones). Exclusion criteria were lack of consent or absence of pre-procedural ultrasound assessment. The primary endpoint was a composite of all-cause mortality and heart failure hospitalization within 12 months. Secondary endpoints included VARC-2-defined complications.ResultsAmong 85 patients included in the final analysis the mean age was 80 ± 11 years, 51.8% were male, and 55 (64.7%) had wet lungs. Patients with wet lungs had higher STS-PROM scores (5.2% vs. 3.0%, p < 0.001), but there were no significant differences in the primary outcome (3.8% vs. 6.7%, p = 0.55). Moreover, procedural characteristics and complication rates were similar between groups.ConclusionsPre-procedural LUS was not associated with worse outcomes following TAVI. While LUS may reflect comorbidity burden, its isolated prognostic value in this setting appears limited.
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spelling doaj-art-c2bdcb373dae4293b0d66c83e5f3f6f42025-08-20T03:58:41ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.16264971626497Prognostic role of pre-procedural lung ultrasound in patients undergoing transcatheter aortic valve implantationGuilherme Pinheiro Machado0Pedro Castilhos de Freitas Crivelaro1Gustavo Neves de Araujo2Guilherme Heiden Telo3Luiz Carlos Corsetti Bergoli4Marina Petersen Saadi5Julia Carvalho da Silva6Camila Porto Cardoso7Wagner Azevedo8Felipe Costa Fuchs9Marco Wainstein10Cardiology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilCardiology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilCardiology Department, Hospital da Unimed Grande Florianópolis, São José, BrazilCardiology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilCardiology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilCardiology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilFaculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, BrazilFaculty of Medicine, Universidade Federal de Ciências de Saúde de Porto Alegre, Porto Alegre, BrazilFaculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, BrazilCardiology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilCardiology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilBackgroundTranscatheter aortic valve implantation (TAVI) is the preferred treatment for patients with severe aortic stenosis (AS) in patients >75 years. Lung ultrasound (LUS) has emerged as a noninvasive tool for assessing pulmonary congestion and risk stratification in cardiovascular disease, especially heart failure, however, its prognostic role in TAVI remains to be clarified. Therefore, our aim was to investigate the association between pre-procedural LUS findings and clinical outcomes in patients undergoing TAVI.MethodsWe conducted a prospective cohort study of 116 patients undergoing TAVI from 2021 to 2024. Lung ultrasound was performed immediately before the procedure. Patients were classified as having “wet lungs” (≥1 positive zone) or “dry lungs” (no positive zones). Exclusion criteria were lack of consent or absence of pre-procedural ultrasound assessment. The primary endpoint was a composite of all-cause mortality and heart failure hospitalization within 12 months. Secondary endpoints included VARC-2-defined complications.ResultsAmong 85 patients included in the final analysis the mean age was 80 ± 11 years, 51.8% were male, and 55 (64.7%) had wet lungs. Patients with wet lungs had higher STS-PROM scores (5.2% vs. 3.0%, p < 0.001), but there were no significant differences in the primary outcome (3.8% vs. 6.7%, p = 0.55). Moreover, procedural characteristics and complication rates were similar between groups.ConclusionsPre-procedural LUS was not associated with worse outcomes following TAVI. While LUS may reflect comorbidity burden, its isolated prognostic value in this setting appears limited.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1626497/fulltranscatheter aortic valve replacementall-cause mortalityaortic stenosislung ultrasound (LUS)heart failure
spellingShingle Guilherme Pinheiro Machado
Pedro Castilhos de Freitas Crivelaro
Gustavo Neves de Araujo
Guilherme Heiden Telo
Luiz Carlos Corsetti Bergoli
Marina Petersen Saadi
Julia Carvalho da Silva
Camila Porto Cardoso
Wagner Azevedo
Felipe Costa Fuchs
Marco Wainstein
Prognostic role of pre-procedural lung ultrasound in patients undergoing transcatheter aortic valve implantation
Frontiers in Cardiovascular Medicine
transcatheter aortic valve replacement
all-cause mortality
aortic stenosis
lung ultrasound (LUS)
heart failure
title Prognostic role of pre-procedural lung ultrasound in patients undergoing transcatheter aortic valve implantation
title_full Prognostic role of pre-procedural lung ultrasound in patients undergoing transcatheter aortic valve implantation
title_fullStr Prognostic role of pre-procedural lung ultrasound in patients undergoing transcatheter aortic valve implantation
title_full_unstemmed Prognostic role of pre-procedural lung ultrasound in patients undergoing transcatheter aortic valve implantation
title_short Prognostic role of pre-procedural lung ultrasound in patients undergoing transcatheter aortic valve implantation
title_sort prognostic role of pre procedural lung ultrasound in patients undergoing transcatheter aortic valve implantation
topic transcatheter aortic valve replacement
all-cause mortality
aortic stenosis
lung ultrasound (LUS)
heart failure
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1626497/full
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