Omari M, Ibrahim M, Abukhalaf O, Abdalwahab A, Edwards R, Das R, Zaman A, Farag M, Alkhalil M. Differences in cardiac output of patients undergoing trans-catheter aortic valve implantation according to their underlying rhythm. World J Cardiol 2026; 18(2): 110803 [DOI: 10.4330/wjc.v18.i2.110803]
Corresponding Author of This Article
Mohammad Alkhalil, PhD, Consultant, Department of Cardiothoracic Services, Freeman Hospital, Freeman Road, Newcastle NE7 7DN, Newcastle upon Tyne, United Kingdom. mohammad.alkhalil@nhs.net
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Cardiac & Cardiovascular Systems
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Observational Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 26, 2026 (publication date) through Feb 9, 2026
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World Journal of Cardiology
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1949-8462
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Omari M, Ibrahim M, Abukhalaf O, Abdalwahab A, Edwards R, Das R, Zaman A, Farag M, Alkhalil M. Differences in cardiac output of patients undergoing trans-catheter aortic valve implantation according to their underlying rhythm. World J Cardiol 2026; 18(2): 110803 [DOI: 10.4330/wjc.v18.i2.110803]
World J Cardiol. Feb 26, 2026; 18(2): 110803 Published online Feb 26, 2026. doi: 10.4330/wjc.v18.i2.110803
Differences in cardiac output of patients undergoing trans-catheter aortic valve implantation according to their underlying rhythm
Muntaser Omari, Miray Ibrahim, Omran Abukhalaf, Ahmed Abdalwahab, Richard Edwards, Rajiv Das, Azfar Zaman, Mohamed Farag, Mohammad Alkhalil
Muntaser Omari, Miray Ibrahim, Omran Abukhalaf, Ahmed Abdalwahab, Richard Edwards, Rajiv Das, Azfar Zaman, Mohamed Farag, Cardiothoracic Centre, Freeman Hospital, Newcastle NE7 7DN, Newcastle upon Tyne, United Kingdom
Muntaser Omari, Azfar Zaman, Mohammad Alkhalil, Translational and Clinical Research Institute, Newcastle University, Newcastle NE1 7RU, Newcastle upon Tyne, United Kingdom
Mohammad Alkhalil, Department of Cardiothoracic Services, Freeman Hospital, Newcastle NE7 7DN, Newcastle upon Tyne, United Kingdom
Author contributions: Omari M, Ibrahim M, Abukhalaf O, and Abdalwahab A contributed to investigation and resources; Omari M and Alkhalil M contributed to project administration and writing-original draft; Edwards R, Das R, Zaman A, Farag M, and Alkhalil M contributed to methodology and supervision. All authors contributed to writing-review, editing the manuscript, and approval the final manuscript.
Institutional review board statement: This study was exempted from Institutional Review Board Approval because it was a retrospective analysis of anonymized clinical dataset.
Informed consent statement: This study is a retrospective investigation and has been granted an exemption from informed consent requirements.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data can be requested from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammad Alkhalil, PhD, Consultant, Department of Cardiothoracic Services, Freeman Hospital, Freeman Road, Newcastle NE7 7DN, Newcastle upon Tyne, United Kingdom. mohammad.alkhalil@nhs.net
Received: June 16, 2025 Revised: July 20, 2025 Accepted: November 21, 2025 Published online: February 26, 2026 Processing time: 238 Days and 18.6 Hours
Abstract
BACKGROUND
The recent Cardiac Output in Patients with Small Annuli Undergoing Transcatheter Aortic Valve Implantation with Self-Expanding vs Balloon Expandable Valve (COPS-TAVI) study provided some insights into the differences in cardiac output in patients with small aortic annuli undergoing transcatheter aortic valve implantation (TAVI) according to the implanted platform: Balloon-expandable (BEV) vs self-expanding valves (SEV).
AIM
To investigate the understudied role of atrial fibrillation (AF) on cardiac output in patients undergoing TAVI.
METHODS
The COPS-TAVI study enrolled consecutive patients with severe aortic stenosis and small annuli who underwent successful TAVI. Cardiac output was measured using echocardiography within 4 weeks following TAVI. Data were analyzed according to the presence of AF and stratified by SEV or BEV.
RESULTS
A total of 138 patients were included in the analysis, of whom 22% had AF. Cardiac output was significantly lower in patients with AF compared to those without it (4.6 L/minute vs 5.3 L/minute, P = 0.02). Consistent with the main study findings, the difference in cardiac output was evident among patients without AF who underwent SEV vs BEV (P < 0.05). On the other hand, there was no difference in cardiac output in patients with AF, irrespective of the implanted platform (P > 0.05). There was no difference in clinical outcomes between the two groups.
CONCLUSION
Cardiac output, as measured by echocardiography, was larger in patients with small annuli who underwent TAVI procedure with SEV compared to BEV in patients without AF. This observation should be considered during procedural planning.
Core Tip: Cardiac output, as measured by echocardiography, was larger in patients with small annuli who underwent transcatheter aortic valve implantation procedure with self-expanding valves compared to balloon-expandable in patients without atrial fibrillation. This observation should be considered during procedural planning.
