Abstract 17222: Surgical as Opposed to Transcatheter Aortic Valve Replacement for Aortic Stenosis Improves Associated Basal Septal Hypertrophy/Dysfunction

Background: Basal interventricular septal (IVS) hypertrophy (BSH) is frequently associated with aortic stenosis (AS) and its mechanism is not established. The shape of BSH suggests the possibility of compression from longitudinally elongated ascending aorta, causing regional dysfunction of the BSH (left upper figure). Surgical aortic valve replacement (SAVR), as opposed to transcatheter AVR (TAVR), may potentially improve BSH by shortening longitudinal length of the aorta by incision and stitching (right upper figure). We hypothesized that basal IVS thickness as well as its contraction improves after SAVR, as opposed to TAVR, in patients with AS and associated BSH. Methods: In 32 patients with SAVR and 12 with TAVR to AS, regional wall thickness and systolic contraction (longitudinal strain) of 12 LV segments as well as IVS to aorta angle were measured by echocardiography. Results: After SAVR, basal IVS thickness and its contraction significantly improved (13.5±3.5 to 12.2±2.6 mm, -6.2±5.7 to -9.1±5.2 %, ...